Resource Allocation in a National Dental Service Using Program Budgeting Marginal Analysis

Introduction: In any health system, choices must be made about the allocation of resources (budget), which are often scarce. Economics has defined frameworks to aid resource allocation, and program budgeting marginal analysis (PBMA) is one such framework. In principle, patient and public values can be incorporated into these frameworks, using techniques such as willingness to pay (WTP). However, this has not been done before, and few formal resource allocation processes have been undertaken in dentistry. This study aimed to undertake a PBMA with embedded WTP values in a national dental setting. Methods: The PBMA process was undertaken by a panel of participant-researchers representing commissioners, dentists, dental public health staff, and academics. The panel reviewed current allocations and generated a set of weighted criteria to evaluate services against. Services to be considered for removal and investment were determined by the panel and wider discussion and then scored against the criteria. Values from a nationally representative WTP survey of the public contributed to the scores for interventions. Final decisions on removal and investment were taken after panel discussion using individual anonymous electronic voting. Results: The PBMA process resulted in recommendations to invest in new program components to improve access to general dentists, care home dentistry, and extra support for dental public health input into local government decisions. Disinvestments were recommended in orthodontics and to remove routine scaling and polishing of teeth. Discussion: The PBMA process was successful in raising awareness of resource allocation issues. Implementation of findings will depend on the ability of decision makers to find ways of operationalizing the decisions. The process illustrates practical aspects of the process that future dental PBMAs could learn from. Knowledge Transfer Statement: This study illustrates a framework for resource allocation in dental health services and will aid decision makers in implementing their own resource allocation systems.

PROGRAM BUDGETING IN MANAGING PUBLIC FINANCES

The COVID-19 pandemic and the economic recession significantly reduced the amount of financial resources that were supposed to be used to solve the most acute problems of social development, which caused the need to update and rethink the theoretical and practical experience in the functioning of targeted programs as a tool for managing public finances of the Russian Federation. The article summarizes the problems of developing program budgeting at the present stage, it indicates the sources of their origin. The study was carried out using a set of general scientific methods; empirical results were obtained by observing and collecting data on practical implementation of state and municipal programs from official sources. The authors performed a critical analysis of scientific publications and reports of state and local government bodies on the development of program budgeting and public finance management. The shift in the perspective of scientific research in comparison with the initial stage of implementing the program principles of public finance management is indicated. The authors highlighted the main methodological difficulties that prevent qualitative improving the tools of program budgeting in general, as well as at each of the management levels separately. The key shortcomings in the practical application of program budgeting are formulated and their logical connection with the factors that constrain the pace and influence the vector of socio-economic development of the Russian Federation is indicated. The directions of further improving program budgeting are given and the conditions for on target efficiency of both new and established methods and techniques that affect the final effectiveness of state and municipal programs are stipulated. The results of the study can be used to adjust the strategic and program documents of the authorities in order to improve the management of public finances.

Intergovernmental relations as a problem of program budgeting

The article shows the possibility of solving the problem of horizontal budget equalization withinthe framework of the Russian model of program budgeting, implemented through the system of federal, sub-federal governmental programs and municipal programs. To achieve this goal, it is proposed to solve two interrelated tasks: increasing the budgetary self-sufficiency of the subjects of the Russian Federation and redistributing intergovernmental transfers in accordance with their socio-economic characteristics. To solve the first task the necessity of providing the process of management (development, implementation and monitoring) of governmental and municipal programs with the proposed measures aimed at ensuring control of the ratio of budget expenditures for the implementation of social and commercial projects is substantiated. These measures should be complemented with a time-limited policy of redistributing intergovernmental transfers, taking into account the different socio-economic situation of the subjects of the Russian Federation. For this purpose, test indicators have been calculated to determine the extent to which the annual dynamics of the actual distribution of the volumes of intergovernmental transfers between the subjects of the Russian Federation for each of the eight federal districts for the period 2000–2018 corresponds to the criterion proposed by us in previous works. Those were the negative value of the Spearman's ordinal correlation coefficient between the variables “the share of non-repayable receipts” and “the budgetary self-sufficiency potential”. An attempt is made to establish a correlation relationship between the calculated values of these indicators and the socio-economic characteristics of the federal districts. It is concluded that for a correct assessment of the impact of governmental program budgetingon regional development, it is necessary to take into account the parameters of programs at all levels of the budgetary system of the Russian Federation in the context of a separate territory, i.e. subject of the Russian Federation or their group.

PERENCANAAN PEMBIAYAAN BERBASIS PLANNING PROGRAMMING BUDGETTING SYSTEM (PPBS) DI SEKOLAH DASAR ISLAM TERPADU ANNI’MAH BANDUNG

Perencanaan pembiayan pendidikan yang baik berkontribusi terhadap mutu pengelolaan pendidikan. Perencanaan pembiayaan pendidikan merupakan total biaya yang dikeluarkan baik oleh individu peserta didik, keluarga yang menyekolahkan anak, warga masyarakat perorangan, kelompok masyarakat, maupun yang dikeluarkan oleh pemerintah untuk kelancaran pendidikan. Satuan pendidikan dituntut mampu menyusun perencanaan pembiayaan secara tepat. Permasalahan utama penelitian ini yaitu bahwa satuan pendidikan memerlukan adanya model perencanaan pembiayaan yang dipandang efektif. Penelitian ini bertujuan untuk menggambarkan perencanaan pembiayaan pendidikan Berbasis PPBS (Planning, Programming, Budgeting System). Penelitian menggunakan metode deskriptif kualitatif. Hasil penelitian menemukan bahwa Model PPBS (planning, programming, budgeting system) merupakan model perencanaan, penyusunan program dan penganggaran yang dipandang sebagai suatu sistem yang tak terpisahkan satu sama lainnya. Penelitian ini menyimpulkan bahwa perencanaan pembiayaan berbasis PPBS merupakan proses komprehensif dalam pengambilan keputusan karena model PPBS merupakan suatu pendekatan sistematik yang berusaha untuk menetapkan tujuan, mengembangkan program, menentukan besaran biaya, dan proses penganggaran yang merefleksikan kegiatan program jangka panjang. Perencanaan berbasis PPBS berkontribusi positif pada peningkatan mutu Sekolah Dasar (SD) Islam terpadu (IT) Anni’mah yang teridentifikasi ditandai adanya peningkatan mutu guru, meningkatnya mutu siswa, lingkungan belajar semakin kondusif, disiplin sekolah semakin baik, ketersediaan sumber belajar memadai, partisipasi orang tua meningkat, serta satuan biaya semakin terukur dengan jelas.Kata kunci: Perencanaan, Program, Budgeting Sistem