Clinical management and prioritization criteria. Finnish experiences

The aim of this study was to investigate the acceptability of 14 prioritization criteria from nurses', doctors', local politicians' and the general public's perspective. Respondents (nurses, n = 682, doctors, n = 837 politicians, n = 1,133 and the general public, n = 1,178) received a questionnaire with 16 imaginary patient cases, each containing 2-3 different prioritization criteria. The subjects were asked to indicate how important it was for them that the treatments in the presented patient cases be subsidized by the community. All respondents preferred treatments for poor people and children. With the exception of the doctors, the three other study groups also prioritized elderly patients. Treatment for institutionalised patients, those with self-induced disease, diseases with both poor and good prognosis, and mild disease were given low priorities. Priority setting in health care should be regarded as a continuous process because of changes in attitudes. However, the best method for surveying opinions and ethical principles concerning prioritization has not yet been discovered.