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. 2011;6(8):e23930.
doi: 10.1371/journal.pone.0023930. Epub 2011 Aug 31.

Age as a criterion for setting priorities in health care? A survey of the German public view

Adele Diederich  1 , Jeannette Winkelhage, Norman Wirsik
Affiliations

Age as a criterion for setting priorities in health care? A survey of the German public view

Adele Diederich et al. PLoS One. 2011.

Abstract

Although the German health care system has budget constraints similar to many other countries worldwide, a discussion on prioritization has not gained the attention of the public yet. To probe the acceptance of priority setting in medicine, a quantitative survey representative for the German public (n = 2031) was conducted. Here we focus on the results for age, a highly disputed criterion for prioritizing medical services. This criterion was investigated using different types of questionnaire items, from abstract age-related questions to health care scenarios, and discrete choice settings, all performed within the same sample. Several explanatory variables were included to account for differences in preference; in particular, interviewee's own age but also his or her sex, socioeconomic status, and health status. There is little evidence that the German public accepts age as a criterion to prioritize health care services.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Agreement/disagreement on preferential treatment for elderly.
Proportion of agreement/disagreement to elderly being preferentially treated as a function of the respondents' own age group. The majority of younger and older respondents are in favor of prioritizing elderly.
Figure 2
Figure 2. Hypothetical preference functions for age as prioritization criterion.
The results are based on the proportions of agreement to treat people in different age categories preferentially. Note that the categories were not mutually exclusive. The dashed curve represents the results of total agreement observed for each statement. The dotted curve represents the proportion of agreement of those respondents who accepted preferential treatment of patients in one age category and rejected preferential treatment of patients in the two remaining age categories. They are believed to have a “true” preference for a particular age category.
Figure 3
Figure 3. Agreement to statements for preferential treatments in the life-threatening illness scenario by respondents' age.
Figure 4
Figure 4. Agreement/disagreement allowing an exemption of fixed age limit for health services by respondents' age.
Figure 5
Figure 5. Agreement/disagreement of preferential treatment for younger casualties by respondents' age.
Figure 6
Figure 6. Agreement/disagreement of preferential treatment of younger patients waiting for donor kidney by respondents' age.
Figure 7
Figure 7. Part-worth utilities and their 95% confidence interval for the factor age.
See this image and copyright information in PMC

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