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Cost Effectiveness and Resource Allocation
Published in: Cost Effectiveness and Resource Allocation 1/2017

Open Access 01-12-2017 | Research

Public engagement in setting healthcare priorities: a ranking exercise in Cyprus

Authors: Antonis Farmakas, Mamas Theodorou, Petros Galanis, Georgios Karayiannis, Stefanos Ghobrial, Nikos Polyzos, Evridiki Papastavrou, Eirini Agapidaki, Kyriakos Souliotis

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2017

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Abstract

Background

In countries such as Cyprus the financial crisis and the recession have severely affected the funding and priority setting of the health care system. There is evidence highlighting the importance of population’ preferences in designing priorities for health care settings. Although public preferences have been thorough analysed in many countries, there is a research gap in terms of simultaneously investigating the relative importance and the weight of differing and competing criteria for determining healthcare priority settings. The main objective of the study was tο investigate public preferences for the relative utility and weight of differing and competing criteria for health care priority setting in Cyprus.

Methods

The ‘conjoint analysis’ technique was applied to develop a ranking exercise. The aim of the study was to identify the preferences of the participants for alternative options. Participants were asked to grade in a priority order 16 hypothetical case scenarios of patients with different disease and of diverse socio-economic characteristics awaiting treatment. The sample was purposive and consisted of 100 Cypriots, selected from public locations all over the country.

Results

It was revealed that the “severity of the disease” and the “age of the patient” were the key prioritization criteria. Participants assigned the smallest relative value to the criterion “healthy lifestyle”. More precisely, participants older than 35 years old assigned higher relative importance to “age”, while younger participants to the “severity of the disease”. The “healthy lifestyle” criterion was assigned to the lowest relative importance to by all participants.

Conclusion

In Cyprus, public participation in health care priority setting is almost inexistent. Nonetheless, it seems that the public’s participation in this process could lead to a wider acceptance of the healthcare system especially as a result of the financial crisis and the upcoming reforms implemented such as the establishment of the General System of Health Insurance.
Literature
1.
van Exel J, Baker R, Mason H, Donaldson C, Brouwer W. Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology. Soc Sci Med. 2015;126:128–37.CrossRefPubMed
2.
Jamison DT, Mosley WH. Disease control priorities in developing countries: health policy responses to epidemiological change. Am J Public Health. 1991;81:15–22.CrossRefPubMedPubMedCentral
3.
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:1747–57.CrossRefPubMed
4.
Makundi E, Kapiriri L, Norheim OF. Combining evidence and values in priority setting: testing the balance sheet method in a low-income country. BMC Health Serv Res. 2007;7:152.CrossRefPubMedPubMedCentral
5.
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;318:916–9.CrossRefPubMedPubMedCentral
6.
Winkelhage J, Diederich A. The relevance of personal characteristics in allocating health care resources—controversial preferences of laypersons with different educational backgrounds. Int J Environ Res Public Health. 2012;9:223.CrossRefPubMedPubMedCentral
7.
Defechereux T, Paolucci F, Mirelman A, Youngkong S, Botten G, Hagen TP, Niessen LW. Health care priority setting in Norway a multicriteria decision analysis. BMC Health Serv Res. 2012;12:39.CrossRefPubMedPubMedCentral
8.
Theodorou M, Farmakas A. Public participation in priority setting and health policy: the case of Greece. In: Papazisi SK, editor. Democracy, citizens and health police: participation in decision making, interest groups and patients organizations. Athens: Papazizsi; 2014. p. 185–209.
9.
10.
Kuder LB, Roeder PW. Attitudes toward age-based health care rationing: a qualitative assessment. J Aging Health. 1995;7:301–27.CrossRefPubMed
11.
12.
Ryynänen OP, Myllykangas M, Niemelä P, Kinnunen J, Takala J. Attitudes to prioritization in selected health care activities. Scand J Soc Welf. 1998;7:320–9.CrossRef
13.
14.
Mossialos E, King D. Citizens and rationing: analysis of a European survey. Health Policy. 1999;49:75–135.CrossRefPubMed
15.
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:e23930.CrossRefPubMedPubMedCentral
16.
Lueschen G, Stevens F, van der Zee J, Cockerham WC, Diederijks J, d’Houtaud A, Ferrando MG, Peeters R, Niemann S. Health care systems and the people: a five-nation study in the European Union. Int Sociol. 1994;9:337–62.CrossRef
17.
18.
Shmueli A. Horizontal equity in medical care: a study of the Israeli public’s views. Isr Med Assoc J. 2000;2:746–52.PubMed
19.
Nord E, Richardson J, Street A, Kuhse H, Singer P. Who cares about cost? Does economic analysis impose or reflect social values? Health Policy. 1995;34:79–94.CrossRefPubMed
20.
Schwappach DL, Strasmann TJ. “Quick and dirty numbers”? The reliability of a stated-preference technique for the measurement of preferences for resource allocation. J Health Econ. 2006;25:432–48.CrossRefPubMed
21.
Tymstra T, Andela M. Opinions of Dutch physicians, nurses, and citizens on health care policy, rationing, and technology. JAMA. 1993;270:2995–9.CrossRef
22.
Nord E, Richardson J, Street A, Kuhse H, Singer P. Maximizing health benefits vs egalitarianism: an Australian survey of health issues. Soc Sci Med. 1995;41:1429–37.CrossRefPubMed
23.
Ryynanen OP, Myllykangas M, Kinnunen J, Takala J. Attitudes to health care prioritisation methods and criteria among nurses, doctors, politicians and the general public. Soc Sci Med. 1999;49:1529–39.CrossRefPubMed
24.
Oddsson K. Assessing attitude towards prioritizing in healthcare in Iceland. Health Policy. 2003;66:135–46.CrossRefPubMed
25.
Beauchamp TL, Faden RR. The right to health and the right to health care. J Med Philos. 1979;4:118–31.CrossRefPubMed
26.
Stefanini A. Ethics in health care priority-setting: a north-south double standard? Trop Med Int Health. 1999;4:709–12.CrossRefPubMed
27.
Cookson R, Dolan P. Public views on health care rationing: a group discussion study. Health Policy. 1999;49:63–74.CrossRefPubMed
28.
Green C, Gerard K. Exploring the social value of health-care interventions: a stated preference discrete choice experiment. Health Econ. 2009;18:951–76.CrossRefPubMed
29.
Wilmot S, Ratcliffe J. Principles of distributive justice used by members of the general public in the allocation of donor liver grafts for transplantation: a qualitative study. Health Expect. 2002;5:199–209.CrossRefPubMedPubMedCentral
30.
Scuffham PA, Whitty JA, Taylor M, Saxby RC. Health system choice: a pilot discrete-choice experiment eliciting the preferences of British and Australian citizens. Appl Health Econ Health Policy. 2010;8:89–97.CrossRefPubMed
31.
Watson V, Carnon A, Ryan M, Cox D. Involving the public in priority setting: a case study using discrete choice experiments. J Public Health (Oxf). 2012;34:253–60.CrossRef
32.
Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy. 2003;2:55–64.PubMed
33.
Louviere JJ, Hensher DA, Swait JD. Stated choice methods: analysis and applications. Cambridge: Cambridge University Press; 2000.CrossRef
34.
Green PE, Srinivasan V. Conjoint analysis in consumer research: issues and outlook. J Consum Res. 1978;5:103–23.CrossRef
35.
Deal K. Getting started with conjoint analysis. Mark Res. 2005;17:42.
36.
37.
Schibrowsky JA, Collins RH. Microcomputer applications: the brand manager’s statistical package: SPSS’s categories module. J Pers Sell Sales Manag. 1990;10:97–100.
38.
Lees A, Scott N, Scott SN, MacDonald S, Campbell C. Deciding how NHS money is spent: a survey of general public and medical views. Health Expect. 2002;5:47–54.CrossRefPubMedPubMedCentral
39.
Liss P-E. the significance of the goal of health care for the setting of priorities. Health Care Anal. 2003;11:161–9.CrossRefPubMed
40.
Hauck K, Smith P, Goddard M. The economics of priority setting for health care: a literature review. Washington, DC: The World Bank; 2004.
41.
42.
Kapiriri L, Norheim OF. Criteria for priority-setting in health care in Uganda: exploration of stakeholders’ values. Bull World Health Organ. 2004;82:172–9.PubMedPubMedCentral
43.
44.
45.
Arvidsson E, Andre M, Borgquist L, Carlsson P. Priority setting in primary health care-dilemmas and opportunities: a focus group study. BMC Fam Pract. 2010;11:71.CrossRefPubMedPubMedCentral
46.
Taylor C. Philosophical arguments. Cambridge: Harvard University Press; 1995.
47.
Kohn ML, Naoi A, Schoenbach C, Schooler C, Slomczynski KM. Position in the class structure and psychological functioning in the United States, Japan, and Poland. Am J Sociol. 1990;95:964–1008.CrossRef
48.
Charny MC, Lewis PA, Farrow SC. Choosing who shall not be treated in the NHS. Soc Sci Med. 1989;28:1331–8.CrossRefPubMed
49.
Johannesson M, Johansson P-O. The economics of ageing: on the attitude of Swedish people to the distribution of health care resources between the young and the old. Health Policy. 1996;37:153–61.CrossRefPubMed
50.
Busschbach JJV, Hessing DJ, De Charro FT. The utility of health at different stages in life: a quantitative approach. Soc Sci Med. 1993;37:153–8.CrossRefPubMed
51.
Tsuchiya A. Age-related preferences and age weighting health benefits. Soc Sci Med. 1999;48:267–76.CrossRefPubMed
52.
Rodriguez E, Pinto JL. The social value of health programmes: is age a relevant factor? Health Econ. 2000;9:611–21.CrossRefPubMed
53.
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;57:687–96.CrossRefPubMed
54.
Dolan P, Shaw R, Tsuchiya A, Williams A. QALY maximisation and people’s preferences: a methodological review of the literature. Health Econ. 2005;14:197–208.CrossRefPubMed
55.
Zweibel NR, Cassel CK, Karrison T. Public attitudes about the use of chronological age as a criterion for allocating health care resources. Gerontologist. 1993;33:74–80.CrossRefPubMed
56.
Judge K, Mulligan J, New B. The NHS: new prescriptions needed. In: Jowell R, Curtice J, Park A, Brook L, Thomson K, Bryson C, editors. British social attitudes: the 14th report: the end of conservative values?. Farnham: Ashgate; 1997. p. 49–72.
57.
Kneeshaw J. What does the public think about rationing? A review of the evidence. In: New B, editor. Rationing: talk and action in health care. London: British Medical Journal Publishing and King’s Fund; 1997. p. 58–78.
58.
Fattore G. Clarifying the scope of Italian NHS coverage. Is it feasible? Is it desirable? Health Policy. 1999;50:123–42.CrossRefPubMed
59.
King D, Maynard A. Public opinion and rationing in the United Kingdom. Health Policy. 1999;50:39–53.CrossRefPubMed
60.
Gallego G, Taylor SJ, McNeill P, Brien JA. Public views on priority setting for high cost medications in public hospitals in Australia. Health Expect. 2007;10:224–35.CrossRefPubMedPubMedCentral
61.
62.
63.
Schwappach DLB. Does it matter who you are or what you gain? An experimental study of preferences for resource allocation. Health Econ. 2003;12:255–67.CrossRefPubMed
64.
Myllykangas M, Ryynanen OP, Lammintakanen J, Isomaki VP, Kinnunen J, Halonen P. Clinical management and prioritization criteria: finnish experiences. J Health Organ Manag. 2003;17:338–48.CrossRefPubMed
65.
Elo IT. Social class differentials in health and mortality: patterns and explanations in comparative perspective. Annu Rev Sociol. 2009;35:553–72.CrossRef
66.
Buyx AM. Personal responsibility for health as a rationing criterion: why we don’t like it and why maybe we should. J Med Ethics. 2008;34:871–4.CrossRefPubMed
Metadata
Title
Public engagement in setting healthcare priorities: a ranking exercise in Cyprus
Authors
Antonis Farmakas
Mamas Theodorou
Petros Galanis
Georgios Karayiannis
Stefanos Ghobrial
Nikos Polyzos
Evridiki Papastavrou
Eirini Agapidaki
Kyriakos Souliotis
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2017
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/s12962-017-0078-3

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