Evidence map›Paper›PMID 42129063›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2026

Building consensus on what to include in public health expenditures: A modified Delphi study in Canada.

Mehdi Ammi, Farzaneh Davarzani, Maeva Doumbia, Breanna Wodnik, Ak'ingabe Guyon, Jasmine Pawa, Sara Allin

Abstract read
PubMed Publisher
In one paragraph

Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mehdi AmmiSchool of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada. mehdi.ammi@carleton.ca.ORCID http://orcid.org/0000-0002-8409-3309
Farzaneh DavarzaniSchool of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada.
Maeva DoumbiaSchool of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada.
Breanna WodnikInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-1304-0194
Ak'ingabe GuyonÉcole de Santé Publique de L'Université de Montréal, Montréal, Quebec, Canada.ORCID http://orcid.org/0009-0002-8764-4011
Jasmine PawaDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Sara AllinInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Funding

CIHR 178261
6 · The paper itself

Abstract

objectivesAn accurate understanding of expenditures on public health in Canada is necessary to assess value for money and advocate for sustainable public health systems. Our objective was to determine a consensus-based list of public health expenditure items.

methodsWe conducted a two-round, online modified Delphi study with public health physicians from across Canadian provinces. Participants rated the extent to which expenditure items in existing Canadian expenditure records should be classified as public health. In round 1, 78 expenditure items were assessed. In round 2, only items lacking consensus were reappraised considering the group's earlier ratings.

resultsTwenty-two public health physicians across Canada participated in round 1. Consensus was reached for 46 items, most (37 items) judged outside of public health. In round 2, the 32 items without prior consensus were returned for reassessment, and consensus was reached for 20 items, again with most (17 items) excluded from public health. Screening programs and health emergency preparedness were judged within public health expenditures, while chronic disease management and primary care services were judged outside.

conclusionPublic health physicians agreed that most items they rated (54 of 78) belong in funding streams other than public health. Current estimates of public health expenditures may therefore be overstated, with implications for the sustainability of public health systems in Canada.

Indexed as

CanadaData standardizationDelphi techniqueHealth expendituresPublic health

Identifiers

PMID42129063

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.