Setting priorities in preventative services

Abstract

We investigate opinions regarding which preventative services should be given priority funding; the importance of primary, secondary and tertiary prevention; and bivariate associations between the respondents’ sociodemographics, health status and lifestyle and their preferences. Computer-assisted personal interviews (CAPI) were conducted with participants from a regional quota sampling by sex, age and socioeconomic status (SES) in Germany. Participants were asked to indicate whether they would keep the status quo, expand or reduce health-care provision for eight primary, six secondary and four tertiary preventative services. Furthermore, they stated the importance of primary, secondary and tertiary prevention on a four-point Likert scale. Data were evaluated using contingency analysis and correspondence analyses. One hundred and three people completed the survey. The majority of participants opted for expanding non-medical primary preventative services like health education and counselling and for expanding secondary preventative services like cancer screening. For tertiary prevention, like rehabilitation, the desired service distribution depends on the specific preventative services. There were few differences in answers to the questions on the importance of the provision in primary, secondary and tertiary prevention. Bivariate associations between the respondents’ characteristics like age, SES, health status and lifestyle and their preferences could be observed. Primary preventative services and disease detection should receive more funds. No consistent pattern could be detected for tertiary prevention. Respondents expressed some differences of opinion on the importance of types of prevention. The differences are related to knowledge, personal circumstances and interests of the respondents.