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Physicians' attitudes toward health care rationing.
Thomas V Perneger1, Diane P Martin, Patrick A Bovier
1Quality of Care Unit, Geneva University Hospitals, Switzerland. thomas.perneger@hcuge.ch
Summary
Swiss physicians prioritize equitable health service allocation over maximizing lives saved. They prefer medical associations, not lotteries, to make difficult rationing decisions.
Area of Science:
- Health Economics
- Medical Ethics
- Public Health Policy
Background:
- Healthcare resource allocation under budget constraints is a contentious issue.
- Key debates involve balancing efficiency versus equity and decision-making authority.
- This study investigates Swiss physicians' perspectives on healthcare rationing.
Purpose of the Study:
- To understand Swiss physicians' views on healthcare rationing.
- To explore preferences for efficiency versus equity in resource allocation.
- To determine preferred methods for selecting beneficiaries for limited, superior treatments.
Main Methods:
- A mail survey of 1,184 physicians in Geneva, Switzerland.
- Physicians evaluated a scenario comparing a suboptimal universal screening test versus a superior selective test.
- Respondents were randomly assigned to different selection methods for the superior test: lottery, first-come-first-served, or medical associations.
Main Results:
- Only 26% of physicians favored the more effective selective rationing strategy.
- Acceptance of selective rationing varied by selection method: lottery (14%), first-come-first-served (26%), and medical associations (39%).
- Hospital-based physicians and general practitioners were less inclined towards selective rationing than community-based physicians and specialists.
Conclusions:
- Swiss physicians lean towards equitable distribution of health services over maximizing overall health outcomes.
- Physicians prefer to be the decision-makers in healthcare rationing scenarios.
- The findings highlight a preference for physician-led, equity-focused resource allocation.