Who should participate in health care priority setting and how should priorities be set? Evidence from a Portuguese survey

2015),"Suicide rates for different religious groups in the South Asian origin population in England and Wales: a secondary analysis of a national data set"Access to this document was granted through an Emerald subscription provided by emerald-srm:451335 [] For AuthorsIf you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to seek to elicit, in a context of economic crisis, the social preferences for the microallocation of scarce healthcare resources. Design/methodology/approach -Data were collected from an online questionnaire which includes a hypothetical rationing choice scenario with four patients differentiated by their personal characteristics and health states competing for treatments and a set of statements that embodies: distributive criteria for prioritizing patients; the authorship of these types of decisions; and the likelihood of these decisions to be taken. Descriptive statistics, factor analysis and non-parametric test were used for describing and validating the data. Findings -Findings suggest that respondents: support a pluralism of distributive principles in prioritizing patients with an incident in utilitarianism and the reducing of inequalities in health, translated in the fair-inning and in emotional arguments of fragility; trust in the health professional to make prioritization decisions; and are conscious that rationing decisions will be real in the short term. Practical implications -The pursuit of efficiency and the equalizing of a lifetime health seem to be the criteria that should guide any rationing policy at the micro level. Originality/value -This study addresses simultaneously several ethical principles inherent to microallocation healthcare resources in a suitable context in which Portugal is facing an economic crisis and where, consequently, rationing healthcare policies gain prominence on the political agenda.

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“…These preferences are consistent with those obtained in other international studies and also for Portugal (Botelho et al, 2014 for a revision).…”

Section: Discussionsupporting

confidence: 92%

Bedside healthcare rationing dilemmas: a survey from Portugal

Pinho

Borges²

2015

International Journal of Human Rights in Healthcare

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“…Differences between the views of public and health professionals raise interesting questions about the role that citizen participation in health decision making should take and how the results of studies such as this should be used. For example, previous evidence suggest that Portuguese population wish to be consulted in matters of rationing health care but do not want the responsibility of having to make those kinds of decisions, that is, they believe doctors should play the most important role in rationing decisions (Botelho, Pinho, & Veiga, 2014). Whoever makes the decisions, it is important to ensure that those decisions are not grossly discordant with the views of members of the public on whose behalf the decisions are being made.…”

Section: Discussionmentioning

confidence: 99%

The Views of Health Care Professionals and Laypersons Concerning the Relevance of Health-Related Behaviors in Prioritizing Patients

Pinho

Borges²

2019

Health Educ Behav

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This article aims to investigate to what extent health care professionals in Portugal find health-related behaviors relevant as a criterion to priority setting, to study what type of risk behavior they consider relevant in such decisions and to compare their views with those of laypersons. An online questionnaire was used to collect data from a sample of 178 health care professionals and 295 laypersons. The statistical analysis was performed through the application of generalized linear models and logistic regressions. Health professionals consider more than laypersons that information about health-related behaviors is relevant in prioritization between individuals. Both groups regard information about illegal drug abuse, excessive alcohol consumption, and smoking more important to priority setting decisions than information about overweight or lack of physical exercise. The findings are important for the definition of rationing policies as the professionals’ decisions are those that, ultimately, influence health expenditure.

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“…We raise challenging questions about the role that citizen participation in health decision-making should take and how the results of studies such as this should be used. For example, previous evidence (Botelho et al , 2014) suggests that the Portuguese population wishes to be consulted in matters of rationing healthcare but does not want the responsibility of having to make those kinds of decisions. Whoever makes the decisions, it is important to ensure that they are not grossly discordant with the views of members of the public on whose behalf the decisions are being made.…”

Section: Discussionmentioning

confidence: 99%

A three-country survey of public attitudes towards the use of rationing criteria to set healthcare priorities between patients

Pinho

Borges

2018

International Journal of Ethics and Systems

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Purpose The purpose of this study is to explore and compare citizens’ attitudes in Portugal, Bulgaria and Croatia towards rationing criteria that should support an explicit priority setting process at the micro level. Design/methodology/approach Preferences were collected through an online questionnaire containing 14 statements concerning lottery, economic and person-based priority criteria. Respondents indicated their level of agreement with each criterion. Non-parametric tests were applied to compare the levels of agreement among 355, 298 and 243 Portuguese, Bulgarian and Croatian respondents, respectively. Findings The three groups of respondents appear to be concerned with both a fair and efficient allocation of resources. The severity of health conditions and patient’s age were the criteria most accepted by the respondents. This study suggests that Portuguese, Bulgarian and Croatian respondents have similar social values concerning patient prioritization, although the Portuguese adhere slightly more to efficiency criteria and less to person-based and lottery criteria than Bulgarian and Croatian respondents. Practical implications A majority of respondents across the three countries report having opinion about the bedside rationing criteria. Portuguese, Bulgarian and Croatian respondents accept a combination of personal and economic criteria in patient’s prioritization. Originality/value This study represents the first attempt to compare citizen’s opinions of three member states of the European Union. Paper type Research paper

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Who should participate in health care priority setting and how should priorities be set? Evidence from a Portuguese survey

Cited by 12 publications

References 21 publications

Bedside healthcare rationing dilemmas: a survey from Portugal

Bedside healthcare rationing dilemmas: a survey from Portugal

The Views of Health Care Professionals and Laypersons Concerning the Relevance of Health-Related Behaviors in Prioritizing Patients

A three-country survey of public attitudes towards the use of rationing criteria to set healthcare priorities between patients

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