Personality and perceptions about the use of personal responsibility for illness as a health care rationing criteria.

Abstract

Whenever the demand for health care exceeds existing resources, rationing becomes imperative. Current lifestyle-induced illnesses increase the pressure on health systems and actualize the discussion concerning the relevance of personal responsibility in health care allocation decisions. In a publicly financed health care system, it is important that prioritysetting decisions reflect social values. This article explores whether personality traits such as dispositional optimism and tolerance, as well as healthy behaviors, influence preferences for the prioritization of patients based on their lifestyles. An online questionnaire was used to collect data from a sample of 581 Portuguese citizens. Quantitative data analysis was performed through structural equation modeling. The results showed that optimism is positively related to the acceptance of personal responsibility as a bedside rationing criterion, whereas tolerance indicated compassion for the illness of others and, therefore, better adherence to the externalization of responsibility and less responsiveness to accountability. Furthermore, personality did not affect respondents' predisposition to pursue healthy lifestyles, while it turned out to be a more important predictor than healthy behaviors for setting priorities among patients based on personal responsibility. Personality traits like optimism and tolerance proved to be important factors driving social values for health care rationing decisions.

Unveiling the Impact of Personality in Lifestyle Solidarity: An Exploratory Study of the Effects of Dispositional Optimism and Risk Orientation

“…Respondents with either a more positive or negative outlook on the future were more likely to give less priority to patients who contributed to their illness through risky behaviours, although the pessimists were more penalising. This finding partially aligns with recent empirical research (Pinho & Araújo, 2022), suggesting that optimism was positively related to accepting personal responsibility. Our results also corroborate the idea described in the 'Dispositional Optimism' section that optimists easily disengage from goals with unfavourable odds (Geers et al, 2009).…”

“…Besides, another noteworthy finding was that optimists were more prevention-oriented when it comes to their health behaviours in line with other studies (Pänkäläinen et al, 2018;Rogowska et al, 2021;Steptoe et al, 2006), which may explain their lower solidarity with those that somehow neglected their health. However, other empirical findings found no relation between dispositional optimism and own lifestyle (Pinho & Araújo, 2022). We can only speculate about the reasons concerning the lower level of lifestyle solidarity shown by pessimists.…”

“…These eight statements and their scale were derived from some empirical literature (e.g. Bringedal & Feiring, 2011;Pinho & Araújo, 2022). Details of the questions can be found in the first column of Table A2 in the Appendix.…”

“…To the best of the authors' knowledge, only two studies have advanced in this matter by investigating the influence of dispositional optimism on preferences for allocating healthcare resources (Luyten et al, 2019;Pinho & Araújo, 2022). Luyten et al (2019) explored the influence of dispositional optimism on how people set priorities in health using seven attributes, one of which was the link between disease and patients' lifestyles.…”

“…The authors found that more pessimistic individuals resorted less to patients' age attributes when prioritizing them and revealed less predisposition to invest in prevention. Pinho and Araújo (2022) focused on the rationing criterion of patients' lifestyles. The authors explored the influence of two personality traits-dispositional optimism and tolerance, on people's support of using personal responsibility as a criterion to set healthcare priorities.…”