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It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing


  • Broqvist, Mari
  • Garpenby, Peter


Previous studies show that citizens usually prefer physicians as decision makers for rationing in health care, while politicians are downgraded. The findings are far from clear-cut due to methodological differences, and as the results are context sensitive they cannot easily be transferred between countries. Drawing on methodological experiences from previous research, this paper aims to identify and describe different ways Swedish citizens understand and experience decision makers for rationing in health care, exclusively on the programme level. We intend to address several challenges that arise when studying citizens' views on rationing by (a) using a method that allows for reflection, (b) using the respondents' nomination of decision makers, and (c) clearly identifying the rationing level. We used phenomenography, a qualitative method for studying variations and changes in perceiving phenomena. Open-ended interviews were conducted with 14 Swedish citizens selected by standard criteria (e.g. age) and by their attitude towards rationing.

Suggested Citation

  • Broqvist, Mari & Garpenby, Peter, 2015. "It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing," Social Science & Medicine, Elsevier, vol. 128(C), pages 301-308.
  • Handle: RePEc:eee:socmed:v:128:y:2015:i:c:p:301-308
    DOI: 10.1016/j.socscimed.2015.01.043

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    References listed on IDEAS

    1. Wiseman, V. & Mooney, G. & Berry, G. & Tang, K. C., 2003. "Involving the general public in priority setting: experiences from Australia," Social Science & Medicine, Elsevier, vol. 56(5), pages 1001-1012, March.
    2. Martin Bouchard & Chris Wilkins, 2009. "Introduction," Global Crime, Taylor & Francis Journals, vol. 10(1-2), pages 1-5, February.
    3. Bowling, Ann & Jacobson, Bobbie & Southgate, Lesley, 1993. "Explorations in consultation of the public and health professionals on priority setting in an inner London health district," Social Science & Medicine, Elsevier, vol. 37(7), pages 851-857, October.
    4. Litva, Andrea & Coast, Joanna & Donovan, Jenny & Eyles, John & Shepherd, Michael & Tacchi, Jo & Abelson, Julia & Morgan, Kieran, 2002. "'The public is too subjective': public involvement at different levels of health-care decision making," Social Science & Medicine, Elsevier, vol. 54(12), pages 1825-1837, June.
    5. Mossialos, Elias & King, Derek, 1999. "Citizens and rationing: analysis of a European survey," Health Policy, Elsevier, vol. 49(1-2), pages 75-135, September.
    6. Busse, Reinhard, 1999. "Priority-setting and rationing in German health care," Health Policy, Elsevier, vol. 50(1-2), pages 71-90, December.
    7. King, Derek & Maynard, Alan, 1999. "Public opinion and rationing in the United Kingdom," Health Policy, Elsevier, vol. 50(1-2), pages 39-53, December.
    8. Dobrow, Mark J. & Goel, Vivek & Upshur, R. E. G., 2004. "Evidence-based health policy: context and utilisation," Social Science & Medicine, Elsevier, vol. 58(1), pages 207-217, January.
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