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Investigating public preferences on 'severity of health' as a relevant condition for setting healthcare priorities

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  • Green, Colin

Abstract

This study examines the preferences of a sample of the UK general public over the allocation of healthcare resources. Preferences were elicited against scenarios where alternative patient groups are competing for limited resources. Respondents were asked to make a choice between either (i) groups described according to alternative descriptions for severity of health condition, or (ii) groups described according to a broader level of disadvantage (e.g. family income). The survey used a random-location quota sampling approach, and face-to-face interview techniques. Interviews were completed with 261 people in the Southampton area of England. Results showed that the majority or respondents wanted to divide resources equally between competing groups, giving at least equal preference to the more severely affected group, and the more disadvantaged group, regardless of a stated lower potential health gain in these groups compared to alternatives. In the severity of health question 60% indicated that a unit of health gain in a severely affected patient group was of greater social value to that same unit of health gain in a moderately affected patient group, all else equal. When described by level of disadvantage, 80% of respondents stated such a preference, which indicates that they attach a greater social value to a unit of health gain in a disadvantaged patient group, compared to a more advantaged group, all else equal. When given an option to 'opt out' of a difficult decision, and to 'let others choose', very few respondents (5%) took that option, suggesting that the most common stated preference of dividing resource equally between groups may be a true preference, rather than respondents avoiding difficult decisions. When interpreting the findings from the survey, results suggest that preferences reported to give priority to those more severely affected by their health, may also be a reflection of a broader preference to treat those groups classed as worse-off, in empirical studies. Results are discussed against the growing importance of the empirical ethics literature, and the growing needs of health policy makers to seek out an empirical basis upon which to consider the challenges of setting priorities in healthcare.

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  • Green, Colin, 2009. "Investigating public preferences on 'severity of health' as a relevant condition for setting healthcare priorities," Social Science & Medicine, Elsevier, vol. 68(12), pages 2247-2255, June.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:12:p:2247-2255
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    1. Newdick, Christopher, 2005. "Who Should We Treat?: Rights, Rationing, and Resources in the NHS," OUP Catalogue, Oxford University Press, edition 2, number 9780199264186, Decembrie.
    2. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    3. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
    4. Gyrd-Hansen, Dorte, 2004. "Investigating the social value of health changes," Journal of Health Economics, Elsevier, vol. 23(6), pages 1101-1116, November.
    5. Ubel, Peter A., 1999. "How stable are people's preferences for giving priority to severely ill patients?," Social Science & Medicine, Elsevier, vol. 49(7), pages 895-903, October.
    6. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
    7. Oddsson, Kristjan, 2003. "Assessing attitude towards prioritizing in healthcare in Iceland," Health Policy, Elsevier, vol. 66(2), pages 135-146, November.
    8. Nord, Erik, 2005. "Concerns for the worse off: fair innings versus severity," Social Science & Medicine, Elsevier, vol. 60(2), pages 257-263, January.
    9. Cookson, Richard & Dolan, Paul, 1999. "Public views on health care rationing: a group discussion study," Health Policy, Elsevier, vol. 49(1-2), pages 63-74, September.
    10. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
    11. Nord, Erik, 1993. "The trade-off between severity of illness and treatment effect in cost-value analysis of health care," Health Policy, Elsevier, vol. 24(3), pages 227-238, August.
    12. Richardson, Jeff & McKie, John, 2005. "Empiricism, ethics and orthodox economic theory: what is the appropriate basis for decision-making in the health sector?," Social Science & Medicine, Elsevier, vol. 60(2), pages 265-275, January.
    13. Olsen, Jan Abel & Richardson, Jeff & Dolan, Paul & Menzel, Paul, 2003. "The moral relevance of personal characteristics in setting health care priorities," Social Science & Medicine, Elsevier, vol. 57(7), pages 1163-1172, October.
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    5. Gemma Lasseter & Hareth Al-Janabi & Caroline L Trotter & Fran E Carroll & Hannah Christensen, 2018. "The views of the general public on prioritising vaccination programmes against childhood diseases: A qualitative study," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-18, June.
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    7. Franken, Margreet & Stolk, Elly & Scharringhausen, Tessa & de Boer, Anthonius & Koopmanschap, Marc, 2015. "A comparative study of the role of disease severity in drug reimbursement decision making in four European countries," Health Policy, Elsevier, vol. 119(2), pages 195-202.
    8. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    9. Liz Morrell & Sarah Wordsworth & Sian Rees & Richard Barker, 2017. "Does the Public Prefer Health Gain for Cancer Patients? A Systematic Review of Public Views on Cancer and its Characteristics," PharmacoEconomics, Springer, vol. 35(8), pages 793-804, August.
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