Health care priorities as a problem of local resource allocation

The aim of this study was to examine attitudes to prioritization in health care among the general public, politicians, doctors and nurses. The focus in this paper is on the types of services from a perspective that is 'policy analytical'. This study forms part of the wider 'Prioritization in Health Care Project' carried out at the University of Kuopio exploring patient treatment level prioritizations. Data were collected by a postal questionnaire in 1995. Four groups were established for the study: (1) a general public sample of 2000 subjects, (2) a random sample of 1000 nurses, (3) a random sample of 1500 medical doctors and (4) a sample of 2200 politicians involved in social and health care administration. Respondents were asked to make value choices between specialized and primary health care services in a real budget situation. One of the most salient findings in this study was that attitudes towards priorities are context-dependent. Certain differences were observed between the groups studied. The attitudes of the general public and nurses were quite similar, while similar views were shared by politicians and doctors. The attitudes of the respondents reflect well what has actually happened in Finnish health care, with the exception of psychiatric services which have undergone drastic cuts.