How do patients prioritize in situations of limited resources?
Key words
Prioritization, patients, ethics, cataract surgery, major joint replacement
Financial support
The project is made possible by a grant from The Vardal Foundation For Health Care Sciences and Allergy Research (Vårdalstiftelsen) and the Uppsala County Council (Landstinget i Uppsala län.
Objectives
In times of limited resources within the health care sector, a pertinent issue for both health care administrators and politicians is that of making priorities between patients in need of treatment. An interesting aspect is that neither the public, nor the patients themselves, have been involved in discussion on prioritizations. This research project aims to investigate how patients would make priorities among other patients on a waiting-list for major joint (hip- or knee) replacement, when resources are strained and it isn’t possible to provide treatment for all patients. A spectrum of motivations guiding patient priorities will be identified and documented. The prioritizations made by an orthopaedic patient group will be compared to priorities suggested by orthopaedic surgeons, general practitioners, and a representative sample of the general population.
Thirty patients on the waiting list for major joint replacement at the Karolinska University Hospital in Huddinge were invited to participate in the first phase of the study, and experienced orthopaedic surgeons assessed these patients’ relative priority for surgery using a validated clinical scoring instrument. Patients were also asked to complete questionnaires including psychosocial aspects of their health, such as quality of life. From these assessments, 10 patient vignettes, including clinical as well as psychosocial aspects, have been constructed and included in a questionnaire. In the second phase of the study, this questionnaire will be sent to a new group of orthopaedic patients on the waiting list at the Karolinska University Hospital, to a representative sample of the public, and to orthopaedic surgeons and general practitioners.
Publications
Magnusson H, Felländer-Tsai L, Hansson MG and Ryd L, Cancellations of elective surgery may cause an inferior postoperative course: the ’Invisible hand’ of health care prioritization?, Clinical Ethics, 2011;6(1):27-31.
More information:
- Mats G. Hansson, Professor of Biomedical Ethics
Collaborators:
Mats G. Hansson, Professor of Biomedical Ethics
Lilianne Eninger, Associate Professor
Li Tsai, MD, Associate Professor, Orthopaedic Surgery, Karolinska University Hospital, Huddinge
Leif Ryd, MD, Professor of Orthopaedic Surgery, Karolinska University Hospital, Huddinge
Håkan Magnusson, MD, Orthopaedic Surgery, Karolinska University Hospital, Huddinge
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