Resource Allocation Preferences Research Articles

Financial literacy and retirees' resource allocation decisions in New Zealand

We investigate the relationship between financial literacy, debt anxiety, risk tolerance, and subsequent resource allocation decisions for cohorts of retirees. Using a survey and the novel comparative method of Multi-Criteria Decision-Making Analysis we prioritise retirement allocation choices of older New Zealanders. Retirees display high financial literacy and together with debt anxiety this is significantly correlated with resource allocation preferences. Financial literacy reduces debt anxiety in men, increases the risk tolerance of women and is associated with a higher preference for KiwiSaver. Greater debt anxiety is associated with debt repayment, and debt avoidance in old age is critical to long-term wellbeing.

Team and Nation: Sports, Nationalism, and Attitudes Toward Refugees

How do major national events influence attitudes toward non-nationals? Recent research suggests that national sports team wins help foster national pride, weaken ethnic attachments, and build trust among conational out-group members. This paper asks a related question: By heightening nationalism, do these victories also affect attitudes toward foreign out-groups, specifically refugees? We examine this question using the 2019 Africa Cup football match between Kenya and Tanzania, which Kenya narrowly won, coupled with an online survey experiment conducted with a panel of 2,647 respondents recruited through Facebook. We find that winning increases national pride and preferences for resource allocation toward conationals, but it also leads to negative views of refugees’ contribution to the country’s diversity. However, we present experimental evidence that reframing national sports victories as a product of cooperation among diverse players and highlighting shared superordinate identities can offset these views and help foster positive attitudes toward refugees.

Preferences for scarce medical resource allocation: Differences between experts and the general public and implications for the COVID-19 pandemic.

This study concerns what lay people believe is the best way to allocate scarce medical resources. A sample of 515 individuals completed a short questionnaire asking them to rank‐order eight different ethical positions with respect to the allocation of scarce resources. They showed a strong preference for the ‘saves most lives’ and ‘sickest first’ options, with ‘reciprocity’ and a ‘lottery’ being least favoured. There was a reasonable degree of unanimity amongst respondents and comparatively few correlations with individual difference factors such as demography. The preference results are compared to expert recommendations (Emanuel et al., 2020, N. Engl. J. Med., 382, 2049) made in light of the current coronavirus pandemic, and differences are highlighted. Implications for scare medical resource allocations are discussed, and limitations of the study acknowledged.

Eyes on the prize: The preference to invest resources in goals over means.

Goal systems are hierarchical, often requiring people to invest resources vertically-both in lower-order means and higher-order goals. For example, a college student who wants to take a particular class (a goal) might first have to take a prerequisite (the means). We investigated how the hierarchical configuration of goals and means affects preferences for vertical resource allocation. Specifically, we found that within goal-means dyads, people preferred to shift resources toward goals (i.e., invest less in means and more in goals) and further invested more resources in items framed as goals (versus means; Studies 1-2). The preference to shift resources toward goals was moderated by the presence of a goal-means hierarchy within the dyad (Study 3) and mediated by the perception that investing resources in the goal was a more direct investment in goal attainment (Study 4). Moreover, people chose to reduce costs associated with means (versus goals; Study 5) and were happier when costs associated with means (versus goals) were eliminated (Study 6). These studies demonstrate that the aversion to investing resources in means can result in non-normative decision making in the course of goal pursuit. (PsycINFO Database Record

The social values development of preschoolers: An investigation of the joint impact hypothesis.

We investigated the role of sociocultural (between-groups) and individual (within-group) factors on the development of preschoolers' resource-allocation preferences. We tested claims of the joint impact hypothesis of social values development that social-emotional understanding skills would predict the transition from simpler (individualistic allocations) to more complex (cooperative, competitive allocations) social values and that cultural background would determine which values emerged. American children ages 37-67 months from Spanish-speaking Latino (n = 134), English-speaking Latino (n = 50), and English-speaking Caucasian (n = 98) backgrounds twice completed a resource-allocation task and a social-emotional understanding assessment, separated by 6 months. Contrary to predictions, results revealed that for no group were complex choice allocations more common at Time 2 than at Time 1. Moreover, for the Caucasian group, social-emotional understanding did not predict time-dependent choice allocation behavior. For Latinos, however, results revealed differential social values development according to language background. For Spanish-speaking Latinos, higher social-emotional understanding scores predicted emergent cooperative choices, and for English-speaking Latinos, higher scores predicted emergent competitive choices. Findings are consistent with differential socialization wherein social-emotional understanding skills facilitate the development of culturally mainstream values for more acculturated Latinos and ethnic cultural values for less acculturated Latinos. (PsycINFO Database Record

A Three-Choice Minority Game Model with Homogeneous Agent Preferences for Resource Allocation

Microgrids have a promising potential to provide off-grid energy access for rural communities. With the growing interest on microgrids and energy access, there has been a renewed focus on developing demand management schemes appropriate for simple microgrids. One basic demand management concern is the problem of shaping consumer demand profiles such that peaks and troughs can be minimized. This problem can be viewed as a simplified resource allocation problem where each resource choice can only be chosen by a fixed number of agents. This study models the described allocation problem as a three-choice minority game where the resources available to the agents map to energy time-of-use windows. Agents were defined to have a homogeneous preference over these available choices of time windows. Different cost functions were likewise simulated in the game. The specific cost functions used in the simulations were chosen to determine whether agents can be influenced to self-organize such that the total number of agents per time window falls within a defined capacity. Results show that some cost functions successfully maintain agent numbers within the defined capacity. Nevertheless, results also indicate that agent gains may suffer when the capacity per choice is met.

Stakeholder value judgments in decision-making on the incorporation, financing, and allocation of new health technologies in limited-resource settings: a potential Brazilian approach

ABSTRACTObjective.To analyze the value judgments behind cost–benefit tradeoffs made by health stakeholders in deciding whether or not to incorporate new health technologies and how they should be financed and allocated in limited-resource settings in Brazil.Method.From June 2009 to January 2010, a sample of stakeholders in the public and private health sector was identified and invited to complete an online survey consisting of two questionnaires: one collecting socio-demographic/professional information and one capturing resource allocation preferences in four hypothetical scenarios for the incorporation of new health technologies.Results.A total of 193 respondents completed the survey; more than half were male (53.9%) and the most common age group was 31–40 years (36.8%). Scenario 1 (incorporation of a new drug treatment for chronic disease, by reducing/eliminating resources for existing programs) was rejected by 49.2% of the survey sample, who preferred to maintain the status quo for existing programs. Scenario 2 (incorporation of the same new treatment, but financed by a new tax) was rejected by 58.0%. Scenario 3 (incorporation of a new treatment for a highly lethal disease, by age group—20–75 years versus 75+ years—by reducing/eliminating resources for existing programs), was rejected by 42.0%, while 20.7% supported allocations for both groups, 34.2% supported allocations exclusively for the 20–75-year age group, and 3.1% supported allocations exclusively for the 75+ year age group. For Scenario 4, which consisted of five different resource allocations for prevention and treatment programs for another highly lethal disease, the most preferred option (chosen by 50.8% of respondents) was 75%:25% (prevention versus treatment).Conclusions.When incorporating a new health technology requires reducing/eliminating other health programs, financing it through a tax, or having to choose certain age groups (e.g., younger, working people versus older people), respondents are likely to reject it. When offered the choice of limiting the scope of the program (e.g., prevention versus treatment), respondents are likely to favor prevention. This was the first study in Brazil to capture value judgments that affect stakeholder decision-making on various resource allocations for different scenarios for health technology introduction in limited-resource settings. Future research should investigate the perspective of society as a whole to determine the best approach for decision-making based on common values and consensus within a particular health care system.

Cost-Value Analysis of Health Interventions: Introduction and Update on Methods and Preference Data

According to the consensus statement from the International Society for Pharmacoeconomics and Outcomes Research Quality-Adjusted Life-Year (QALY) workshop in Philadelphia in 2007 "concerns for fairness may cause social resource allocation preferences to deviate considerably from the ranking that consideration of costs per QALY would suggest." Salient concerns for fairness include the view that priority should be given to the severely ill over the less severely ill, that people have a right to realize their potential for health even if their capacity to benefit from treatment is moderate, and that everybody has the same right to treatment that averts premature death, even if their health and functional level is less than perfect. Cost-value analysis incorporates these concerns in formal economic evaluation of health interventions and programs and thus has a potential for ranking interventions and programs in a way that is more consistent with societal values. Data on the strength of public concerns for fairness are now sufficient to be useful in formal economic evaluation. The data may, within a context of fair and open deliberations, help societal decision makers to roughly indicate the societal value of a QALY in different circumstances and thus determine a tentative grading of willingness to pay for a QALY.

Activity in the Nucleus Accumbens and Amygdala Underlies Individual Differences in Prosocial and Individualistic Economic Choices

Much decision-making requires balancing benefits to the self with benefits to the group. There are marked individual differences in this balance such that individualists tend to favor themselves whereas prosocials tend to favor the group. Understanding the mechanisms underlying this difference has important implications for society and its institutions. Using behavioral and fMRI data collected during the performance of the ultimatum game, we show that individual differences in social preferences for resource allocation, so-called "social value orientation," is linked with activity in the nucleus accumbens and amygdala elicited by inequity, rather than activity in insula, ACC, and dorsolateral pFC. Importantly, the presence of cognitive load made prosocials behave more prosocially and individualists more individualistically, suggesting that social value orientation is driven more by intuition than reflection. In parallel, activity in the nucleus accumbens and amygdala, in response to inequity, tracked this behavioral pattern of prosocials and individualists. In addition, we conducted an impunity game experiment with different participants where they could not punish unfair behavior and found that the inequity-correlated activity seen in prosocials during the ultimatum game disappeared. This result suggests that the accumbens and amygdala activity of prosocials encodes "outcome-oriented emotion" designed to change situations (i.e., achieve equity or punish). Together, our results suggest a pivotal contribution of the nucleus accumbens and amygdala to individual differences in sociality.

The development of tag-based cooperation via a socially acquired trait

Recent theoretical models have demonstrated that phenotypic traits can support the non-random assortment of cooperators in a population, thereby permitting the evolution of cooperation. In these “tag-based models”, cooperators modulate cooperation according to an observable and hard-to-fake trait displayed by potential interaction partners. Socially acquired vocalizations in general, and speech accent among humans in particular, are frequently proposed as hard to fake and hard to hide traits that display sufficient cross-populational variability to reliably guide such social assortment in fission–fusion societies. Adults’ sensitivity to accent variation in social evaluation and decisions about cooperation is well-established in sociolinguistic research. The evolutionary and developmental origins of these biases are largely unknown, however. Here, we investigate the influence of speech accent on 5–10-year-old children's developing social and cooperative preferences across four Brazilian Amazonian towns. Two sites have a single dominant accent, and two sites have multiple co-existing accent varieties. We found that children's friendship and resource allocation preferences were guided by accent only in sites characterized by accent heterogeneity. Results further suggest that this may be due to a more sensitively tuned ear for accent variation. The demonstrated local-accent preference did not hold in the face of personal cost. Results suggest that mechanisms guiding tag-based assortment are likely tuned according to locally relevant tag-variation.

Setting priorities for non-regulatory animal health in Ireland: Results from an expert Policy Delphi study and a farmer priority identification survey

Agriculture is a very important contributor to the Irish economy. In Ireland, national animal health services have been a government, rather than an industry, responsibility. In 2009, Animal Health Ireland (AHI) was established to provide a partnership approach to national leadership of non-regulatory animal health issues (those not subject to national and/or EU regulation). The objectives of this study were to elicit opinion from experts and farmers about non-regulatory animal health issues facing Irish livestock industries, including prioritisation of animal health issues and identification of opportunities to maximise the effective use of AHI resources. The study was conducted with experts using Policy Delphi methodology over three rounds, and with farmers using a priority identification survey. Non-regulatory bovine diseases/conditions were prioritised by both experts and farmers based on impact and international competitiveness. For each high-priority disease/condition, experts were asked to provide an assessment based on cost, impact, international perception, impediment to international market access and current resource usage effectiveness. Further information was also sought from experts about resource allocation preferences, methods to improve education and coordination, and innovative measures to improve prevention and management. There was close agreement between responses from experts and dairy farmers: each gave highest priority to 3 diseases with a biosecurity risk (subsequently termed ‘biosecure diseases’) (bovine viral diarrhoea [BVD], infectious bovine rhinotracheitis [IBR], paratuberculosis) and 4 diseases/conditions generally without a biosecurity risk (‘non-biosecure diseases/conditions’) (fertility, udder health/milk quality, lameness, calf health). Beef farmers also prioritised parasitic conditions and weanling pneumonia. The adverse impact of biosecure diseases is currently considered relatively minor by experts, but would increase substantially in time. There are already substantial costs to farms and agribusiness from non-biosecure diseases/conditions. Experts preferred an equal allocation of resources between these biosecure and non-biosecure diseases/conditions, with emphasis on adopting/adapting international models, education and awareness-raising. The results from this study provide robust insights about non-regulatory animal health priorities in Ireland, as perceived by experts and farmers, using methodologies that are both transparent and inclusive. They have already been extremely influential in shaping national policy, as a foundation for interdisciplinary (and multi-agency) cooperation, as a contribution to efforts to encourage stakeholder responsibility-taking, and to ongoing development of postgraduate and undergraduate veterinary education in Ireland.

Eliciting preferences for resource allocation in mental health care in Ireland

The proportion of total health care expenditure devoted to mental health care in Ireland, at just below 7%, is low relative to other countries. There have been few studies that have examined the relationship between public preferences for different kinds of health care expenditure and priority setting as undertaken by policy-makers and governments. This paper examines citizen's rankings and willingness to pay for a community-based mental health care programme in Ireland relative to two other programmes: cancer and elderly care. Respondents rank cancer as the most important programme, followed by elderly care and then mental health care. The contingent valuation survey demonstrated that people are willing to make significant tax contributions to new community-based services for people with mental health problems, counteracting the view sometimes expressed that people do not care at all about mental health care provision. However, the survey also found that people tend to value additional spending on mental health care lower than cancer and elderly care programmes.

Preferences of the public regarding cutbacks in expenditure for patient care

Increasing costs for patient care may necessitate financial cuts in the health-care budget. Our aim is to examine whether the public prefers cuts for psychiatric rather than medical conditions and how resource allocation preferences are related to illness beliefs and attitudes. A telephone survey involving German adult population was conducted in 2004 (n = 1012). Participants were presented with a list of nine medical and mental diseases including alcoholism, depression, schizophrenia, Alzheimer's disease, cancer, diabetes, rheumatism and AIDS, and were asked to name three conditions where they would prefer to see health-care resources cut. For all conditions we asked about personal attitudes and illness beliefs. People were more willing to have financial resources cut for psychiatric than for medical conditions, with resources for alcoholism having the least public backing. Alzheimer's disease was rated more favourably compared to other mental disorders. Generally, the perception of the severity of a disease was associated with resource allocation decisions, favouring those conditions that were considered to be severe. Mental diseases evoked a far greater desire for social distance than most medical diseases which had considerable influence on resource allocation preferences. The perception of personal responsibility had, in contrast, only limited effect on resource allocation decisions. It varied considerably in the case of psychiatric conditions but was not fundamentally different among medical and mental diseases. Personal susceptibility, treatment effectiveness and the perceived life-threat posed by a disease also had limited effects. According to public resource allocation preferences psychiatric patients are at risk of being structurally discriminated within the health-care system.

Alcoholism: Illness beliefs and resource allocation preferences of the public

Background Alcohol-dependent patients are at risk of being denied necessary care because of their diagnosis. We sought to find out whether public illness beliefs influence resource allocation decisions of the public, thus putting alcohol-dependent patients at a disadvantage compared to those suffering from other medical and mental disorders. Method A telephone survey involving the adult German population was conducted in 2004 ( n = 1012). Participants were asked to name three out of nine conditions for which they would prefer resources not to be cut should general cutbacks within the health care budget be necessary. For all conditions we asked about personal attitudes and illness beliefs. Results Schizophrenia and alcoholism were chosen least frequently when it was a question of being spared from budget reductions. Compared to other diseases, alcoholism was considered to be particularly self-inflicted and evoked a high desire for social distance. The perceived severity of the disease, the perceived own risk of becoming alcohol dependent, and the notion that alcoholics are themselves responsible for their illness were associated with resource allocation decisions. Conclusion Alcohol-dependent patients are at risk of being structurally discriminated within the health care system.

“Quick and dirty numbers”?: The reliability of a stated-preference technique for the measurement of preferences for resource allocation

We investigated the reliability of an internet-based stated-preference survey to elicit preferences for priority setting using a conjoint study like approach. Preferences were elicited among members of an Internet survey panel in an experimental “allocation of points” task at two times. The main finding is that the survey showed good reliability and most participants consistently adjusted their allocations of points to differences in presented scenarios. At the repetition of the survey, respondents were more likely to prioritize between new treatment programs competing for funding and those that did prioritize discriminated stronger between programs. We found no evidence that respondents were making easy choices or arbitrarily “clicked” through the survey.

Are Preferences for Equality a Matter of Perspective?

Many subjects attach equal value to different health care programs in surveys eliciting preferences for resource allocation. It has been suggested that subjects may be prepared to attach different priority if they were asked to evaluate someone else's decision instead of adopting the role of a social decision maker. This study investigated whether the perspective individuals are asked to adopt affects their priority setting decisions and the likelihood of assigning equal value to health care programs. 1253 members of an Internet panel were presented a set of clinical vignettes describing preventive health care initiatives and were asked to prioritize among these. They choose between "discrimination," that is, allocating all resources on the better program, and "equality," that is, dividing the resources equally between programs while reducing efficiency. Respondents were randomized to either of 4 survey versions that differed in terms of perspective (evaluator vs. decision maker) and expert status (expert vs. layperson) of the role to be adopted. Subjects in the evaluator perspectives were more likely to choose equality over discrimination between patients as compared to those in the social decision-maker perspectives, regardless of expert status (odds ratios 2.09 and 2.03, P<0.0001). Excess rates of equality choices in the evaluator frames resulted from passive acceptance of equality decisions and active revision of prioritization decisions. Preferences for an equal allocation of resources are strongly affected by decision-making perspective but stable across expert status of the adopted role.

Stigmatizing attitudes about mental illness and allocation of resources to mental health services.

This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; [1993]. Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with mental illness and treatment efficacy. Fifty four individuals participated in a larger study of education about mental health stigma. Participants completed various measures of resource allocation preferences for mandated treatment and rehabilitation services, attributions about people with mental illness, and factors that influence allocation preferences including perceived treatment efficacy. Results showed significant attitudinal correlates with resource allocation preferences for mandated treatment, but no correlates to rehabilitation services. In particular, people who pity people with mental illness as well as those that endorse coercive and segregated treatments, were more likely to rate resource allocation to mandated care as important. Perceived treatment efficacy was also positively associated with resource allocation preferences for mandated treatment. A separate behavioral measure that involved donating money to NAMI was found to be inversely associated with blaming people for their mental illness and not being willing to help them. Implications of these findings on strategies that seek to increase resources for mental health programs are discussed.

Lack of multiplicative transitivity in person trade-off responses.

The person trade-off (PTO) is a technique for eliciting preferences for resource allocation across patient groups. In principle PTO responses should satisfy a requirement of multiplicative transitivity, i.e. that if people consider treatment of 1 in state A to be equivalent to treating 10 in state B, and 1 in state B to be equivalent to 10 in state C, then they should find 1 in state A equivalent to 100 in state C. Earlier studies addressing labelled diseases (specific diagnoses), have shown multiplicative intransitivity of the PTO responses. Our purpose was to test multiplicative transitivity in the case of health states described with the EuroQol instrument only and to find a possible framing effect such as the number of persons in the reference intervention. Forty-four master degree students were asked to fill in a questionnaire addressing four chronic health states. Their task consisted in (1). ranking the states by severity, (2). valuing each of them by the means of the time trade-off, and (3). doing the PTO for all the 10 possible pairwise combinations of the four chronic states plus a fatal one. In a subsequent questionnaire the number of persons in the reference intervention in the PTO was increased from 10 to 100. Multiplicative transitivity was studied in subjects who demonstrated a willingness to trade off and consistency in ranking individual values. None of the 39 subjects included satisfied a minimum multiplicative transitivity requirement in PTO responses. Internal consistency was not improved when the PTO involved health states close to each other in terms of severity, nor when the prevention of death was not the reference intervention. For the 22 subjects having answered both types of questionnaire, increasing the number of persons in the reference intervention did not improve multiplicative transitivity. The PTO holds promise as a useful method for determining social preferences for priority setting, inasmuch as it captures distributive concerns that individual utility techniques such as the time trade-off do not address. But the lack of multiplicative transitivity in PTO responses is unsatisfactory, and ways to reduce this problem need to be explored.

Does it matter who you are or what you gain? An experimental study of preferences for resource allocation.

Using an experimental conjoint-analysis like approach, preferences for resource allocation were studied. An interactive survey was developed which was published in the World Wide Web. A convenience sample of undergraduate students participated in the study. Subjects were confronted with nine pairwise scenarios describing hypothetical patient groups in need of life-saving treatments. The patient groups presented differed in terms of their health-related lifestyle, socioeconomic status, age, life expectancy, quality of life after treatment and whether they had received extensive medical care in the past. Participants were asked to allocate a finite budget to each patient group. All attributes used in this study significantly influenced respondents' preferences on how to allocate the budget between patient groups. The general importance of attributes used in the QALY approach is supported by this study with quality of life being a central criterion. The distributional patterns observed were, however, different from those expected when rigorously adhering to the QALY framework: In only a very small fraction of allocations subjects distributed the entire budget strictly on the patient group expecting the highest QALY gain. The vast majority of responders was willing to trade efficiency for a more equal distribution of resources. The approach described can be used to analyze the importance people place on different attributes in resource allocation decisions and to study preferences for the final distribution of resources.

Between- or within-culture variation?: Culture group as a moderator of the relations between individual differences and resource allocation preferences

Recent theoretical discussion of the influence of between- and within-culture factors on social behaviors suggests that both approaches may be useful. The present study was designed to investigate the joint influence of sociocultural (between-group) and individual (within-group) factors on resource allocation preferences. Brazilian ( n=166) and European–American ( n=99) children with ages ranging from 37 to 140 months were administered a resource allocation task, which consisted of distributing rewards to themselves or to an acquaintance. As expected, individualistic resource allocation preferences decreased with age, whereas competitive and cooperative resource allocation preferences increased with age. Culture group, the task-specific cognitive demands, and the gender of the child, however, moderated these age differences. For example, gender differences in resource allocation preferences were stronger among Brazilians as compared to European–Americans and stronger in the reduced cognitive demand condition. Models of cooperative and competitive behaviors that consider the role of culture group, gender, and cognitive development and applied implications are discussed.