Abstract
The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens’ attitudes towards three person-based priority criteria, patients’ smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011) in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents’ attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.
Highlights
An aging population and progress in medical technology generate upward pressure on health care expenditures
Because this study focuses on attitudes towards the prioritization of younger over older people, non-smokers over smokers, and patients with young children over patients without young children, and since the response to the second category is very low (1.7–4.1 per cent), we created a dummy variable for each criterion, each contrasting the first and the third category
None of the three criteria is supported by the majority of respondents, a considerable minority seems to accept the use of patients’ smoking habits, age and parental status as criteria to decide who shall be treated if a choice needs to be made
Summary
An aging population and progress in medical technology generate upward pressure on health care expenditures. The rapid development of new health care technologies leads to annual increases in government health expenditure between two and three per cent [3, 4]. Forecasts indicate that the future costs of medical services may be insufficiently covered by increased social insurance contributions or taxes [5]. If this prediction holds true, the question may not be whether or not explicit priority regulations must be introduced, but which criteria should be used in setting priorities [6,7,8]. Policy makers are well advised to take citizen preferences into account when defining explicit rules of prioritization [9,10]
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