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Attitudes towards priority-setting and rationing in healthcare: an exploratory survey of Swedish medical students
Department of Medical and Health Sciences, Linköping University.
Department of Medical and Health Sciences, Linköping University.
Department of Medical and Health Sciences, Linköping University.ORCID-id: 0000-0001-6138-6427
Department of Medical and Health Sciences, Linköping University.
2009 (engelsk)Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, nr 2, s. 122-130Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-setting's increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care.

AIMS: The aim of this study is threefold. First we wish to explore the level of familiarity with different aspects of priority-setting among graduating medical students. Secondly, to gauge their acceptance of both established and proposed Swedish priority-setting principles. Finally to elucidate their attitudes towards healthcare rationing and the role of different actors in decision making, with a particular interest in comparing the attitudes of medical students with data from the literature examining the attitudes among primary care patients in Sweden.

METHODS: A cross-sectional survey containing 14 multiple choice items about priority-setting in healthcare was distributed to the graduating medical class at Linkoöping University. The response rate was 92% (43/47).

RESULTS: Less than half of respondents have encountered the notion of open priority-setting, and the majority believed it to be somewhat or very unclear. There is a high degree of awareness and agreement with the established ethical principles for priority-setting in Swedish health care; however respondents are inconsistent in their application of the cost-effectiveness principle. A larger proportion of respondents were more favourable to physicians and other health personnel being responsible for rationing decisions as opposed to politicians.

CONCLUSIONS: Future discussion about priority-setting in medical education should be contextualized within an explicit and open process. There is a need to adequately clarify the role of the cost-effectiveness principle in priority-setting. Medical students seem to acknowledge the need for rationing in healthcare to a greater extent when compared with previous results from Swedish primary care patients.

sted, utgiver, år, opplag, sider
2009. Vol. 37, nr 2, s. 122-130
Emneord [en]
Ethical principles, healthcare, medical education, priority-setting, rationing, Sweden
HSV kategori
Identifikatorer
URN: urn:nbn:se:rkh:diva-1590DOI: 10.1177/1403494808100276PubMedID: 19141543OAI: oai:DiVA.org:rkh-1590DiVA, id: diva2:801463
Tilgjengelig fra: 2015-04-09 Laget: 2015-03-17 Sist oppdatert: 2017-12-04bibliografisk kontrollert

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