Abstract
Priority setting criteria in health care are commonly set by politicians on behalf of the public. It is desirable that these criteria are in line with societal preferences in order to gain acceptance for decisions on what health services to provide and reimburse. We study public preferences for the allocation of the health care budget based on age, disease severity and treatment cost. We use data from a web survey where 1,160 respondents provided their views on priority setting criteria in health care. The data was analyzed using multinomial logistic regression analyses and one-sample proportion tests. Between 13 to 25 percent of the respondents agree that age, disease severity and treatment cost are valid criteria for priority setting, whereas 56 to 80 percent support weaker versions of the statements. We also find significant differences within the population; young men are for example more prone to support explicit priority setting criteria. Our results imply a need for trade-offs in health care priority setting if balancing differing preferences among population groups. To achieve a greater understanding for priority setting in general, and for using economic reasoning in particular, there may be a need for more public transparency to make clear that priority setting is inevitable.
 Published: Online December 2019
Highlights
As people live longer and health care innovations offer a growing number of costly intervention options, there is a growing importance of priority setting, highlighting questions of fairness and efficiency (Sabik and Lie, 2008)
3.3 Statistical analysis We show descriptive summary statistics of the answers and conduct one-sample tests of proportion to test if a majority supports the suggested priority setting criteria applicable to age, disease severity, and treatment cost
If we combine statement 1 and 3 this reaches a support of 68 percent (95% confidence interval: 0.66 to 0.71)
Summary
As people live longer and health care innovations offer a growing number of costly intervention options, there is a growing importance of priority setting, highlighting questions of fairness and efficiency (Sabik and Lie, 2008). 82-89 83 provide or, perhaps more controversially, not to provide, raises questions about values and principles in the health care system (Buxton and Chambers, 2011). Public attitudes towards priority setting in health care are diverse (Peacock, 2015) and decisions may or may not reflect the preferences of those affected, not least due to lack of information on public preferences (Carlsson et al, 2012). Criteria for priority setting and reimbursement are made by politicians on behalf of the general public, whose risk and well-being as payers and patients are affected by these decisions. Guiding principles are set at the political level, actual prioritization has to be made by a range of different actors, including clinicians facing individual patients, and hospital/regional care organizations deciding on reimbursement and coverage
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