Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 29;102(39):e34993.
doi: 10.1097/MD.0000000000034993.

Resource allocation decisions under pandemic conditions: A cross-sectional survey of Ontario physicians

Raiza S Rivera  1 , Joanna E Anderson  2 , Brian Dewar  3 , Edmund S H Kwok  4 , Tim Ramsay  3 , Dar Dowlatshahi  3   5 , Robert Fahed  3   5 , Claire Dyason  5 , Michel Shamy  3   5
Affiliations

Resource allocation decisions under pandemic conditions: A cross-sectional survey of Ontario physicians

Raiza S Rivera et al. Medicine (Baltimore). .

Abstract

The COVID-19 pandemic has forced physicians to confront difficult choices regarding the allocation of scarce resources, such as ventilators and critical care beds. Developing policies to guide the allocation of such resources has proven challenging. An understanding of physicians' attitudes and beliefs surrounding resource allocation could help inform policymaking. As a replication and extension of a survey of Ottawa physicians conducted in 2020, we surveyed physicians across Ontario, Canada in April 2021. This survey examined physicians' sense of preparedness to allocate critical care resources during the pandemic, attitudes concerning resource allocation policy, and approaches to resource allocation decision-making. Of the 253 responses included for analysis, the majority (67%) of respondents indicated feeling "somewhat" or "a little prepared" to make resource allocation decisions, while 20% indicated feeling "not at all prepared." Most respondents (86%) agreed that a policy to guide resource allocation in the event of scarcity should exist. Physicians overwhelmingly agreed that important factors to consider when making resource allocation decisions included the patient likelihood of survival, frailty index, comorbidities, and cognitive status. Responses from the province-wide survey conducted in 2021 resemble the results of an analogous survey of Ottawa physicians conducted in 2020. Physicians generally felt underprepared to make resource allocation decisions and agreed that official policies should guide such decisions. Identification of factors relevant to resource allocation was remarkably consistent across this sample and that taken in 2020.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Physician preparedness.
Figure 2.
Figure 2.
Physician preparedness by specialty.
Figure 3.
Figure 3.
Expected emotional difficulty of providing palliative care.
Figure 4.
Figure 4.
Physician preference in allocation decisions.
Figure 5.
Figure 5.
Physician prioritization of important factors.
Figure 6.
Figure 6.
Physician ranking of factors.
See this image and copyright information in PMC

References

    1. Lai J, Ma S, Wang Y, et al. . Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Network Open. 2020;3:e203976. - PMC - PubMed
    1. Hummel S, Oetjen N, Du J, et al. . Mental health among medical professionals during the COVID-19 pandemic in Eight European Countries: cross-sectional survey study. J Med Int Res. 2021;23:e24983. - PMC - PubMed
    1. Sasaki N, Asaoka H, Kuroda R, et al. . Sustained poor mental health among healthcare workers in COVID-19 pandemic: a longitudinal analysis of the four-wave panel survey over 8 months in Japan. J Occ Health. 2021;63:12227–32. - PMC - PubMed
    1. Canadian Institute for Health Information. COVID-19’s impact on hospital services. Canadian Institute for Health Information. 2021. Available at: https://www.cihi.ca/en/covid-19-resources/impact-of-covid-19-on-canadas-... [access date February 1, 2022].
    1. Ontario COVID-19 Science Advisory Table. Critical care capacity during the COVID-19 pandemic. 2021. Available at: https://covid19-sciencetable.ca/sciencebrief/critical-care-capacity-duri... [access date January 1, 2022].