Introduction: It is argued that by virtue of their financial contributions, the public has a right to be involved in decisions regarding resource allocation in health. As the allocation of resources with fiscal constraints becomes more difficult, decision makers are increasingly faced with difficult tradeoffs between costs and perceived benefits. Consumer involvement is seen as an "ethically attractive" way of dealing with these decisions.

Objective:

(1) To examine the published literature for methodologies used to obtain consumer participation in health resource allocation.
(2) To develop a framework to incorporate consumer participation in resource allocation in health in Australia.

Methods:

The Medline (1966+), Exerpta Medica (1974+), Health Planning and Administration (1975+) and Current Contents databases were searched for articles on health resource allocation and decision making with the terms "public", "lay", "citizen" and "consumer". The bibliographies of key articles, policy statements and health policy references were searched.

Results:

Only six examples of consumer participation in resource allocation have been found so far. The bibliography search has suggested that many examples remain unpublished as policy documents for State Health departments and local government authorities. These have largely relied on low level participation by consumers using polling and survey techniques. Only a few have attempted to incorporate the views of consumers and these have used facilitated group discussions. Most have avoided the consideration of costs.

Discussion:

Consumer participation in resource allocation is poorly indexed in the current biomedical literature and many examples remain unpublished. This makes systematic reviews of this area difficult.