Nested Dynamics of Metropolitan Processes and Policies: Turin

BACKGROUND PAPERS FOR THE METROPOLITAN STUDY: 3 -- The project "Nested Dynamics of Metropolitan Processes and Policies" was initiated by the Regional and urban Development Group at IIASA in 1983 and work on this collaborative study started the same year. This Series of contributions represents "entry tickets" to the Project, i.e., initial statements by authors from individual metropolitan regions that are participating in the Project's network. The aim of these papers is threefold. First, to provide some background information describing the processes of change within four principal subsystems: population, housing, economy, and transportation. Second, to identify major trends and crucial policy issues which are to constitute a focus for the subsequent analytical and modeling work. Third, to facilitate comparative studies of development paths among these regions and the dynamic interdependencies between the above subsystems. The background information contained in this paper pertains to the Turin metropolitan region

Technology assessment and resource allocation for predictive genetic testing: A study of the perspectives of Canadian genetic health care providers

<p>Abstract</p> <p>Background</p> <p>With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada.</p> <p>Methods</p> <p>The authors conducted semi-structured interviews with 16 senior lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized.</p> <p>Results</p> <p>Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing.</p> <p>Conclusion</p> <p>Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate.</p