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Revista de Salud Pública

Print version ISSN 0124-0064


PINHO, Micaela  and  PINTO BORGES, Ana. Economic decisions on who to treat when resources are not enough for everyone. Evidence from a Spanish survey. Rev. salud pública [online]. 2018, vol.20, n.5, pp.584-590. ISSN 0124-0064.


To analyze the attitudes of Spanish citizens towards the criteria that should be used as a guide to make decisions regarding the prioritization of patients, namely, medical, economic and person-based criteria.


An online self-administered questionnaire was used to collect data from a sample of 546 Spanish respondents. The questionnaire was made up of three questions. In the first two questions respondents faced a hypothetical rationing dilemma involving four patients (differentiated by personal characteristics and health conditions) where they were asked to: (i) choose only one patient to be treated and (ii) rank the patients' assistance priority order. As for the third question, respondents were asked to state their level of agreement with 14 healthcare rationing criteria through a five-point Likert scale. Descriptive statistics, factor analysis and multinomial regressions were used.


Findings suggest that Spanish respondents support a plurality of views on the rationing principles on which healthcare micro allocation decisions should be based. Despite the fact respondents support the idea that all patients should receive healthcare assistance equally, they also consider the age of the patient, as well as economic factors when establishing assistance priories among patients.


If it is not possible to provide health care assistance and treatments to all people, then age and economic factors should guide healthcare priority setting.

Keywords : Healthcare rationing; economics; ethics; social values; public opinion (source: MeSH, NLM).

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