TY - JOUR

T1 - Who prefers the 'cost-effectiveness ratio' prioritization approach in health-care decisions?

T2 - Results of an empirical analysis

AU - Damm, Kathrin

AU - Prenzler, Anne

AU - Zuchandke, Andy

PY - 2015/12

Y1 - 2015/12

N2 - Background: The problem of resource scarcity has led to an on-going debate about priority setting in the health-care system. Prioritization via the economic-based cost-effectiveness ratio (CER), for example, is controversial and has many advocates as well as opponents. Hence, the aim of our research is to analyse the fairness consideration of the CER approach in comparison with other prioritization approaches and to investigate whether these preferences depend on the field of study. Methods: We developed and tested a unique questionnaire. Between October 2011 and January 2012, freshmen and advanced university students of medicine, law, economics, philosophy and religion in Germany were asked to choose among four prioritization approaches (CER, minimum health, random selection and age) using a dichotomous choice technique. The data were analysed by descriptive and microeconometric regression techniques. Results: Data on 913 students were included in the study. A majority of the students prioritized cost-effectiveness second after minimum health. Advanced economics students preferred the CER approach significantly more than did incoming economics students. The attitudes of the advanced philosophy/religion students towards the CER were significantly more negative compared with the respective freshmen. Further, gender had a strong, significant impact on attitudes: women chose the CER less often than men did (P < 0.01). Conclusion: The results of this study indicate that attitudes presented by opinion leaders in the investigated fields of study seem to be in line with the perceptions of the respective fields' advanced students. Because of these differences, the debate on how to deal with scarce resources may remain complicated.

AB - Background: The problem of resource scarcity has led to an on-going debate about priority setting in the health-care system. Prioritization via the economic-based cost-effectiveness ratio (CER), for example, is controversial and has many advocates as well as opponents. Hence, the aim of our research is to analyse the fairness consideration of the CER approach in comparison with other prioritization approaches and to investigate whether these preferences depend on the field of study. Methods: We developed and tested a unique questionnaire. Between October 2011 and January 2012, freshmen and advanced university students of medicine, law, economics, philosophy and religion in Germany were asked to choose among four prioritization approaches (CER, minimum health, random selection and age) using a dichotomous choice technique. The data were analysed by descriptive and microeconometric regression techniques. Results: Data on 913 students were included in the study. A majority of the students prioritized cost-effectiveness second after minimum health. Advanced economics students preferred the CER approach significantly more than did incoming economics students. The attitudes of the advanced philosophy/religion students towards the CER were significantly more negative compared with the respective freshmen. Further, gender had a strong, significant impact on attitudes: women chose the CER less often than men did (P < 0.01). Conclusion: The results of this study indicate that attitudes presented by opinion leaders in the investigated fields of study seem to be in line with the perceptions of the respective fields' advanced students. Because of these differences, the debate on how to deal with scarce resources may remain complicated.

KW - Attitude

KW - Empirical analysis

KW - Germany

KW - Health care

KW - Priority setting

UR - http://www.scopus.com/inward/record.url?scp=84955169740&partnerID=8YFLogxK

U2 - 10.1111/hex.12209

DO - 10.1111/hex.12209

M3 - Article

C2 - 24905558

AN - SCOPUS:84955169740

VL - 18

SP - 2413

EP - 2424

JO - Health expectations

JF - Health expectations

SN - 1369-6513

IS - 6

ER -