Should Lifestyles Be a Criterion for Healthcare Rationing? Evidence from a Portuguese Survey

Area of Science:

• Public Health
• Health Economics
• Bioethics

Background:

• Investigated public attitudes towards resource allocation in healthcare based on personal responsibility and lifestyle choices.
• Examined variations in penalizing risky behaviors across different sociodemographic characteristics and health habits.

Purpose of the Study:

• To evaluate whether personal responsibilities should influence healthcare resource allocation.
• To determine if attitudes toward penalizing risky behaviors vary by sociodemographic factors and health habits.

Main Methods:

• A cross-sectional online survey was distributed via social networks in Portugal over six months in 2015.
• 296 valid responses were collected from individuals aged 18 and older.
• Logistic regression analysis explored the relationship between sociodemographic/behavioral factors and the likelihood of assigning lower healthcare priority to individuals with risky behaviors (smoking, alcohol consumption, unhealthy diet, illegal drug use).

Main Results:

• Illegal drug use was the most penalized behavior (65.5%), followed by heavy drinking (61.5%) and smoking (51.0%). Unhealthy dieting received the least penalization (29.7%).
• Sociodemographic characteristics significantly impacted the penalization of risky behaviors.
• Strong agreement existed that smoking, unhealthy diets, excessive alcohol consumption, and illegal drug use should warrant lower priority in healthcare access.

Conclusions:

• Respondents demonstrated acceptance of the concept of healthcare rationing influenced by individual lifestyle choices.
• Public attitudes support differentiating healthcare access based on engagement in unhealthy behaviors.