Bedsides healthcare rationing dilemmas

We investigate the views of Bulgarian citizens on the principles that
should guide microallocation healthcare resources and compare them
directly with those of Portuguese citizens. A self-administered online
questionnaire was used to collect data from a sample of 298 Bulgarian
citizens, using methods from a matching previous study in Portugal.
Respondents faced a hypothetical rationing exercise where they had to
choose and order four patients (differentiated by personal and health
characteristics) and a set of statements that embodied: (i) distributive
criteria for prioritizing patients, (ii) who should prioritize
patients, and (iii) the likelihood of these prioritization decisions
being real. Descriptive statistics, factor analysis, and non-parametric
test were used. Findings suggest that Bulgarian respondents: (i) support
a plurality of distributive principles to underpin healthcare priority
setting with an incident on the severity of health conditions, on
utilitarianism and on reducing health inequalities; (ii) trust in the
health professional to make prioritization decisions and (iii) do not
seem to believe that patients' prioritization will ever become real.
While Bulgarian and Portuguese respondents support a number of shared
ethical principles they place a different level of importance to each.
Bulgarians value mainly the age criterion in prioritizing patients,
whereas Portuguese revealed a greater concern about efficiency.