Asking the public: Citizens´ views on priority setting and resource allocation in democratically governed healthcare

Broqvist, Mari

doi:10.3384/diss.diva-146217

Cited by 3 publications

(4 citation statements)

References 144 publications

(316 reference statements)

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“…Moreover, this should involve dialoguing between the various stakeholders that could be affected by these priorities, including citizens (Broqvist, 2018). When nursing priorities remain implicit, important democratic values such as openness and fair and equal access to basic goods and services are threatened.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, nurses have an extensive impact on people's access to care and the provision of nursing to individual patients without these prioritization processes and decisions being either explicit or transparent. In democratic countries, it is important to make prioritization processes and decision‐making regarding rationing explicit and open to public scrutiny (Broqvist, 2018; Daniels, 2008). One place to start is to determine whether and how national policy documents address prioritization within nursing care.…”

Section: Introductionmentioning

confidence: 99%

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Visibility of nursing in policy documents related to health care priorities

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Visibility of nursing in policy documents related to health care priorities

et al. 2020

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“…The principles of the ethics platform are ordered in such a way that the cost-benefit principle is subordinate to both the human dignity principle and the needs-solidarity principle (Sandman 2015 ). “The principle of human dignity [should be taken into account] before the principle of needs-solidarity, and the same relation should apply between the principle of needs-solidarity and the principle of cost-effectiveness” (Broqvist 2018 , 24). The parliamentary decision on the government bill addressing priorities in healthcare was taken in 1997 (Regeringens proposition 1996 /97:60).…”

Section: Prioritization In Swedish Healthcare: a Summarymentioning

confidence: 99%

Medium-Range Narratives as a Complementary Tool to Principle-Based Prioritization in Sweden: Test Case “ADHD”

Jaarsma

Gelhaus²

2018

Bioethical Inquiry

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In this paper, for the benefit of reflection processes in clinical and in local, regional, and national priority-setting, we aim to develop an ethical theoretical framework that includes both ethical principles and medium-range narratives. We present our suggestion in the particular case of having to choose between treatment interventions for attention deficit hyperactivity disorder (ADHD) and treatment interventions for other conditions or diseases, under circumstances of scarcity. In order to arrive at our model, we compare two distinct ethical approaches: a generalist (principles) approach and a particularist (narratives) approach. Our focus is on Sweden, because in Sweden prioritization in healthcare is uniquely governmentally regulated by the “ethics platform.” We will present a (fictional) scenario to analyse the strengths and weaknesses of the generalist principled perspective of the ethics platform and the particularist perspective of narrative ethics. We will suggest an alternative (moderately particularist) approach to prioritization, which we dub a “principles plus medium-range narratives” approach. Notwithstanding the undeniably central role of principles in distributive justice, we claim that medium-range narratives concerning individuals or groups who stand to benefit or lose from ADHD prioritization practices should also be read or listened to and taken into account at all levels of priority-setting. These narratives are expected to ethically optimize clinical priority-setting, as well as that undertaken at local, regional, and national levels.

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“…Decision makers should be particularly interested in understanding the public's priorities for several reasons: a) in a democracy public policy should serve the public and b) a policy that is not acceptable to the public will be more difficult to implement and c) priorities in health services cannot be solved only by authority's perspective since social values play a central role in the difficult tradeoff dilemma of prioritizing some service over others (Kaplan & Baron-Epel, 2015). Nevertheless, even when policymakers state that decision making should take into account the position of the public, they tend to make a subjective assessment of public opinion which is neither systematically obtained nor reliable (Kaplan & Baron-Epel, 2016) Public opinion surveys asking the public about their priorities are continuously conducted all over the world (Alsabah et al, 2020;Blendon et al, 2001;Bowling, 1996;Broqvist, 2018;Farmakas et al, 2017;Honigsbaum, 2018;Kaplan & Baron-Epel, 2015;Manafo `et al, 2018;Mak et al, 2011;Pinhoet al, 2018;Tolley & Whynes, 1995;Wouters et al, 2017). Usually, in such these surveys the public is asked to choose from a list of options including usually items that are all "good things to have" what is more important to them.…”

mentioning

confidence: 99%

What Does the Public Prefer Versus What Is the Public Ready to Forgo?

Kaplan

Connelly

2021

Eval Health Prof

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The present study uses a novel approach to assess the publics’ ability to cope with priority setting and rationing in health care by asking what the public is willing to forego. Items for disinvestment were presented in three separated dimensions: Categories of medical care, quality of service, and items representing social values. A telephone survey was conducted among a representative sample of the Israeli public (N = 609). The response rate was 51%. We identify a few items that a high proportion of the population express readiness to forgo: a drug for smoking cessation, budgets for improving appearance and comfort in medical facilities, and a product for preventing surgical scars. Furthermore, over a quarter of the public was ready to forgo many other items. We found that less than 10% justified their selection in terms of “personally not important to me,” while most respondents evaluated the items they chose to forgo as “less effective or less essential in comparison to others.” The study found that most respondents, when exposed to a range of health system components, were able to identify at least one item that they will be willing to forgo in a time of economic crisis.

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Asking the public: Citizens´ views on priority setting and resource allocation in democratically governed healthcare

Cited by 3 publications

References 144 publications

Visibility of nursing in policy documents related to health care priorities

Visibility of nursing in policy documents related to health care priorities

Medium-Range Narratives as a Complementary Tool to Principle-Based Prioritization in Sweden: Test Case “ADHD”

What Does the Public Prefer Versus What Is the Public Ready to Forgo?

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