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Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Does it matter whose opinion we seek regarding the allocation of healthcare resources? - a case study

Authors: K. Kolasa, T. Lewandowski

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Societal preferences have to be taken into consideration to ensure difficult healthcare decisions are legitimate and acceptable. It has been interesting to ascertain whether attitudes towards the principles of public healthcare resources allocation are homogenous. In particular, it has been thought provoking to ask whether advancement in medical technologies, and growing accessibility issues due to scarcity of healthcare resources, have influenced the beliefs of the general public with regard to allocative principles in recent years. The objective of this study was to compare preferences towards the distribution of healthcare resources between younger and older members of society.

Methods

Discrete choice experiments using the equivalence of numbers technique and the social welfare function were conducted in Poland. Public preferences towards disease severity, and potential to benefit, as well as aversion to inequity, were elicited. In order to ensure full understanding of questions by the older respondents, a pilot study with ten respondents aged 65+ was conducted.

Results

In total, 52 adult respondents (seniors) and 45 students (juniors) were interviewed. While the first were unwilling to trade between different patients, the latter chose a higher number of individuals to compensate for the loss of ten patients with a more severe disease and a higher potential to treat everything else being equal. Juniors were more inequality averse compared to seniors as well.

Conclusions

While the revealed preferences of seniors were egalitarian, juniors were more willing to differentiate between disease severity and potential to benefit. Differences in opinion between juniors and seniors should be considered in open dialogue regarding healthcare rationing. Insight into the preferences towards health maximization of the former group and the egalitarian beliefs of the latter group could be useful for decision makers in the search for public acceptance of allocation of scarce healthcare resources.
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Literature
2.
go back to reference Guido C, Bobbitt P. Tragic choices. New York: W.W.Norton; 1978. p. 18. Guido C, Bobbitt P. Tragic choices. New York: W.W.Norton; 1978. p. 18.
3.
go back to reference Wlezien C. The public as thermostat: dynamics of preferences for spending. Am J Polit Sci. 1995;39(4):981–1000.CrossRef Wlezien C. The public as thermostat: dynamics of preferences for spending. Am J Polit Sci. 1995;39(4):981–1000.CrossRef
4.
go back to reference Nord E. The trade-off between severity of illness and treatment effect in cost-value analysis of health care. Health Policy. 1993;24:227–38.CrossRefPubMed Nord E. The trade-off between severity of illness and treatment effect in cost-value analysis of health care. Health Policy. 1993;24:227–38.CrossRefPubMed
5.
go back to reference Golicki M, Jakubczyk M, Niewada M, Wrona W, Busschbach J. Valuation of EQ-5D health states in Poland: First TTO-based social value set in Central and Eastern Europe. Value Health. 2010;13(2):289–97.CrossRefPubMed Golicki M, Jakubczyk M, Niewada M, Wrona W, Busschbach J. Valuation of EQ-5D health states in Poland: First TTO-based social value set in Central and Eastern Europe. Value Health. 2010;13(2):289–97.CrossRefPubMed
6.
go back to reference Comanor W. The median voter rule and the theory of political choice. J Public Econ. 1976;5(1–2):169–77.CrossRef Comanor W. The median voter rule and the theory of political choice. J Public Econ. 1976;5(1–2):169–77.CrossRef
7.
go back to reference Kolasa K. Are pricing & reimbursement decision making criteria aligned with public preferences regarding allocation principles in the Polish healthcare sector? Expert Rev Pharmacoecon Outcomes Res. 2014;14(5):751–62.CrossRefPubMed Kolasa K. Are pricing & reimbursement decision making criteria aligned with public preferences regarding allocation principles in the Polish healthcare sector? Expert Rev Pharmacoecon Outcomes Res. 2014;14(5):751–62.CrossRefPubMed
8.
go back to reference Nord E, Pinto J, Richardson J, Menzel P, Ubel P. Incorporating societal concerns for fairness in numerical valuations of health programmes. Health Econ. 1999;8:25–39.CrossRefPubMed Nord E, Pinto J, Richardson J, Menzel P, Ubel P. Incorporating societal concerns for fairness in numerical valuations of health programmes. Health Econ. 1999;8:25–39.CrossRefPubMed
10.
go back to reference Dolan P, Tsuchiya A. Determining the parameters in a social welfare function using stated preference data: an application to health. Appl Econ. 2011;43(18):2241–50.CrossRef Dolan P, Tsuchiya A. Determining the parameters in a social welfare function using stated preference data: an application to health. Appl Econ. 2011;43(18):2241–50.CrossRef
11.
go back to reference Tsuchiya A. The value of health at different ages, CHE Discussion Paper184. York: University of York; 2001. Tsuchiya A. The value of health at different ages, CHE Discussion Paper184. York: University of York; 2001.
12.
go back to reference Atella V, Coggins J, Perali F. Aversion to inequality in Italy and its determinants. J Econ Inequal. 2004;2:117–44.CrossRef Atella V, Coggins J, Perali F. Aversion to inequality in Italy and its determinants. J Econ Inequal. 2004;2:117–44.CrossRef
13.
go back to reference Eisenberg D, Freed G. Reassessing how society prioritizes the health of young people. Health Aff. 2007;26(2):345–54.CrossRef Eisenberg D, Freed G. Reassessing how society prioritizes the health of young people. Health Aff. 2007;26(2):345–54.CrossRef
14.
go back to reference Czapiński J, Panek T. Social Diagnosis 2013. Objective and subjective quality of life in Poland [Special issue]. Contemp Econ. 2013;7:268–74. Czapiński J, Panek T. Social Diagnosis 2013. Objective and subjective quality of life in Poland [Special issue]. Contemp Econ. 2013;7:268–74.
16.
go back to reference Rolfe J, Alam K, Windle J, Whitten S. Designing the choice modelling survey instrument for establishing riparian buffers in the Fitzroy Basin, Central Queensland University, Queensland; 2004. p. 8. http://eprints.usq.edu.au/7833/. Access October 20 2011. Rolfe J, Alam K, Windle J, Whitten S. Designing the choice modelling survey instrument for establishing riparian buffers in the Fitzroy Basin, Central Queensland University, Queensland; 2004. p. 8. http://​eprints.​usq.​edu.​au/​7833/​. Access October 20 2011.
17.
go back to reference Pinto-Prades JL. Is the person trade-off a valid method for allocating health care resources? Health Econ. 1997;6:71–81.CrossRefPubMed Pinto-Prades JL. Is the person trade-off a valid method for allocating health care resources? Health Econ. 1997;6:71–81.CrossRefPubMed
20.
go back to reference Miller D. Distributive justice: what the people think. Ethics. 1992;102(3):555–93.CrossRef Miller D. Distributive justice: what the people think. Ethics. 1992;102(3):555–93.CrossRef
21.
go back to reference Schweitzer M. Multiple reference points, framing, and the status quo bias in health care financing decisions. Organ Behav Hum Decis Process. 1995;63(1):69–72.CrossRef Schweitzer M. Multiple reference points, framing, and the status quo bias in health care financing decisions. Organ Behav Hum Decis Process. 1995;63(1):69–72.CrossRef
22.
go back to reference Tversky A. Kahneman D. Judgement under uncertanity: Heuristics and biases. Science; 1974:185(4157):1124–1131. Tversky A. Kahneman D. Judgement under uncertanity: Heuristics and biases. Science; 1974:185(4157):1124–1131.
23.
go back to reference Lim MK, Bae EY, Choi SE, Lee EK, Lee TJ. Eliciting public preference for health-care resource allocation in South Korea. Value Health. 2012;15(1 Suppl):S91–4.CrossRefPubMed Lim MK, Bae EY, Choi SE, Lee EK, Lee TJ. Eliciting public preference for health-care resource allocation in South Korea. Value Health. 2012;15(1 Suppl):S91–4.CrossRefPubMed
25.
go back to reference Cropper ML, Aydede SK, Portney PR. Preferences for life-saving programs: how the public discounts time and age. J Risk Uncertain. 1994;8(3):243–65.CrossRef Cropper ML, Aydede SK, Portney PR. Preferences for life-saving programs: how the public discounts time and age. J Risk Uncertain. 1994;8(3):243–65.CrossRef
26.
go back to reference Tsuchiya A, Dolan P, Shaw R. Measuring people’s preferences regarding ageism in health: some methodological issues and some fresh evidence. Soc Sci Med. 2003;57(4):687–96.CrossRefPubMed Tsuchiya A, Dolan P, Shaw R. Measuring people’s preferences regarding ageism in health: some methodological issues and some fresh evidence. Soc Sci Med. 2003;57(4):687–96.CrossRefPubMed
27.
go back to reference Diederich A, Winkelhage J, Wirsik N. Age as a Criterion for Setting Priorities in Health Care? A Survey of the German Public View. PLoS One. 2011;6(8):e23930.CrossRefPubMedPubMedCentral Diederich A, Winkelhage J, Wirsik N. Age as a Criterion for Setting Priorities in Health Care? A Survey of the German Public View. PLoS One. 2011;6(8):e23930.CrossRefPubMedPubMedCentral
29.
go back to reference Bellemare C, Kroger ES, Soest AHO. Measuring inequity aversion in a heterogeneous population using experimental decisions and subjective probabilities. Econometrica. 2008;76(4):815–39.CrossRef Bellemare C, Kroger ES, Soest AHO. Measuring inequity aversion in a heterogeneous population using experimental decisions and subjective probabilities. Econometrica. 2008;76(4):815–39.CrossRef
30.
go back to reference Dolan P, Cookson R, Ferguson B. Effect of discussion and deliberation on the public’s views of priority setting in health care: focus group study. BMJ. 1999;318(7188):916–9.CrossRefPubMedPubMedCentral Dolan P, Cookson R, Ferguson B. Effect of discussion and deliberation on the public’s views of priority setting in health care: focus group study. BMJ. 1999;318(7188):916–9.CrossRefPubMedPubMedCentral
Metadata
Title
Does it matter whose opinion we seek regarding the allocation of healthcare resources? - a case study
Authors
K. Kolasa
T. Lewandowski
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1210-8

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