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Public preferences for allocating absolute scarce critical healthcare resources during the COVID-19 pandemic.
Pinho, Micaela.
  • Pinho M; Research on Economics, Management and Information Technologies (REMIT), Portucalense University, Porto, Portugal.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 May 25.
Article in English | MEDLINE | ID: covidwho-1238312
ABSTRACT

PURPOSE:

This paper aims to investigate the Portuguese general public views regarding the criteria that should guide critical COVID-19 patients to receive medical devices (ventilators and IUC beds) during the current pandemic context. Based on rationing principles and protocols proposed in ethical and medical literature the authors explore how Portuguese general public evaluates the fairness of five allocation principles "prognosis", "severity of health condition", "patients age", "instrumental value" (frontline healthcare professionals should be prioritized during the pandemic) and "lottery". DESIGN/METHODOLOGY/

APPROACH:

An online questionnaire was used to collect data from a sample of 586 Portuguese citizens. Descriptive statistics and non-parametric tests were used to define a hierarchy of prioritization criteria and to test for the association between respondents support to them and their socio-demographic and health characteristics.

FINDINGS:

Respondents gave top priority to prognosis when faced with absolute scarcity, followed closely by the severity of health condition, patient's age with instrumental value receiving lowest support, on average. However, when the age of the patients was confronted with survival, younger-first principle prevailed over recovery. In a pandemic context, lottery was considered the least fair allocation method. The findings suggest that respondents' opinions are aligned with those of ethicists but are partially in disagreement with the protocol suggested for Portugal. ORIGINALITY/VALUE This study represents the first attempt to elicit public attitudes towards distributive criteria during a pandemic and, therefore, in a real context where the perception is that life and death decisions have to be made.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Public Opinion / Health Care Rationing / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal subject: Health Services Year: 2021 Document Type: Article Affiliation country: JHOM-12-2020-0494

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Public Opinion / Health Care Rationing / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal subject: Health Services Year: 2021 Document Type: Article Affiliation country: JHOM-12-2020-0494