Gerechtigkeit in der Gesundheitsversorgung: eine empirische Untersuchung über die Verteilungspräferenzen medizinischer Laien

  • Similar to other industrial countries, Germanys health care system is confronted with budget constraints and not everything what is possible from a medical point of view can be paid for. Although a fair allocation of health care resources requires generally accepted prioritization criteria, only few attemps have been made to involve the general public in the process of priority setting in medicine. The present study investigates public preferences for the allocation of medical resources whereat it focuses on differences in the preferences of individuals with different social status, age, sex and health. A mixed-methods design is used for combining a qualitative interview study, inferential statistics, and a conjoint analysis. The interview study explores in detail the criteria and underlying principles of justice used to allocate medical services. 32 purposefully selected medical laypersons were interviewed, following a semi-structured questionnaire. The results show that in addition to medical criteria such as therapeutic benefit or severity of illness, the interviewees also draw upon issues such as lifestyle or the patients age. The criteria refer to different principles of justice, such as need or efficiency, and are highly disputed in parts. The conjoint analysis estimates the relative importance of selected priority setting criteria explored in the interview study. 120 purposefully selected participants were asked to rank order hypothetical patients who differed in age, lifestyle, type and severity of illness, improvement in health and treatment costs by priority of treatment. The findings show that the patients age is the most important criterion for the allocation of health care recources, followed by "severity of illness" and "improvement in health". Preferences vary among participants with different social status and sex, which refer to different attitudes towards distributive justice and may reflect different socialization experiences and self-interests.

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Publishing Institution:IRC-Library, Information Resource Center der Jacobs University Bremen
Granting Institution:Jacobs Univ.
Author:Jeannette Winkelhage
Referee:Adele Diederich, Hilke Brockmann, Margrit Schreier, Werner Vogd
Advisor:Adele Diederich
Persistent Identifier (URN):urn:nbn:de:101:1-2013052811907
Document Type:PhD Thesis
Language:German
Date of Successful Oral Defense:2011/05/16
Year of Completion:2011
Date of First Publication:2011/11/11
PhD Degree:Sociology
School:SHSS School of Humanities and Social Sciences
Library of Congress Classification:R Medicine / RA Public aspects of medicine / RA1-418.5 Medicine and the state / RA410-410.9 Medical economics. Economics of medical care. Employment
Other Organisations Involved:Priorisierung in der Medizin - DFG-Forschergruppe FOR655
Call No:Thesis 2011/37

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