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Economic decisions on who to treat when resources are not enough for everyone. Evidence from a Spanish survey
Decisiones económicas respecto a quién tratar cuando los recursos no son suficientes para todos. Evidencia de una encuesta española
DOI:
https://doi.org/10.15446/rsap.v20n5.69558Palavras-chave:
Healthcare rationing, economics, ethics, social values, public opinion (en)Prestación de atención de salud, asignación de recursos para la atención de salud, economía, ética, valores sociales, opinión pública (es)
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Objective To analyze the attitudes of Spanish citizens towards the criteria that should be used as a guide to make decisions regarding the prioritization of patients, namely, medical, economic and person-based criteria.
Methods An online self-administered questionnaire was used to collect data from a sample of 546 Spanish respondents. The questionnaire was made up of three questions. In the first two questions respondents faced a hypothetical rationing dilemma involving four patients (differentiated by personal characteristics and health conditions) where they were asked to: (i) choose only one patient to be treated and (ii) rank the patients’ assistance priority order. As for the third question, respondents were asked to state their level of agreement with 14 healthcare rationing criteria through a five-point Likert scale. Descriptive statistics, factor analysis and multinomial regressions were used.
Results Findings suggest that Spanish respondents support a plurality of views on the rationing principles on which healthcare microallocation decisions should be based. Despite the fact respondents support the idea that all patients should receive healthcare assistance equally, they also consider the age of the patient, as well as economic factors when establishing assistance priories among patients.
Conclusions If it is not possible to provide health care assistance and treatments to all people, then age and economic factors should guide healthcare priority setting.
Objetivo Explorar las actitudes de los ciudadanos españoles hacia los principios que deben guiar las decisiones relativas a la priorización de pacientes.
Métodos Se utilizó un cuestionario auto administrado en línea para recopilar datos de una muestra de 546 encuestados españoles. El cuestionario consta de tres preguntas. En las dos primeras preguntas, los encuestados se enfrentaron a un hipotético dilema de racionamiento con cuatro pacientes (diferenciados por características personales y condiciones de salud) donde tuvieron que: (i) seleccionar un solo paciente para tratar y (ii) clasificar a los pacientes por orden de asistencia. En la tercera pregunta, los encuestados tuvieron que indicar su nivel de acuerdo con 14 criterios de racionamiento a través de una escala de Likert de cinco puntos. Se usaron estadísticas descriptivas, análisis de factores y regresiones multinomiales.
Resultados Los resultados sugieren que los encuestados españoles soportan una pluralidad de puntos de vista sobre los principios de racionamiento que sostengan las decisiones de microasignación de los cuidados de salud. A pesar de que los encuestados apoyan el valor ético de tratar a las personas por igual, también valoran la edad de los pacientes y los factores económicos al establecer las prioridades entre pacientes.
Conclusiones Si las personas no pueden ser tratadas por igual, entonces la edad del paciente y las consideraciones económicas deben apoyar el establecimiento de prioridades de atención médica.
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