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Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public

In Europe, health insurance arrangements are under reform. These arrangements redistribute collectively financed resources to ensure access to health care for all. Allocation of health services is historically based on medical needs, but use of other criteria, such as lifestyle, is debated upon. Doe...

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Autores principales: van der Aa, Maartje J., Paulus, Aggie T. G., Hiligsmann, Mickaël J. C., Maarse, Johannes A. M., Evers, Silvia M. A. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815412/
https://www.ncbi.nlm.nih.gov/pubmed/29442532
http://dx.doi.org/10.1177/0046958017751981
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author van der Aa, Maartje J.
Paulus, Aggie T. G.
Hiligsmann, Mickaël J. C.
Maarse, Johannes A. M.
Evers, Silvia M. A. A.
author_facet van der Aa, Maartje J.
Paulus, Aggie T. G.
Hiligsmann, Mickaël J. C.
Maarse, Johannes A. M.
Evers, Silvia M. A. A.
author_sort van der Aa, Maartje J.
collection PubMed
description In Europe, health insurance arrangements are under reform. These arrangements redistribute collectively financed resources to ensure access to health care for all. Allocation of health services is historically based on medical needs, but use of other criteria, such as lifestyle, is debated upon. Does the general public also have preferences for conditional allocation? This depends on their opinions regarding deservingness. The aim of this study was to gain insight in those opinions, specifically by examining the perceived weight of different criteria in allocation decisions. Based on literature and expert interviews, we included 5 criteria in a discrete choice experiment: need, financial capacity, lifestyle, cooperation with treatment, and package/premium choice. A representative sample of the Dutch population was invited to participate (n = 10 760). A total of 774 people accessed the questionnaire (7.2%), of whom 375 completed it (48.4%). Medical need was overall the most important criterion in determining deservingness (range β = 1.60). Perceived deservingness decreased if claimants had higher financial capacity (1.26) and unhealthier lifestyle (1.04), if their cooperation was less optimal (1.05), or if they had opted for less insurance coverage (0.56). However, preferences vary among respondents, in relation to demographic and ideological factors.
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spelling pubmed-58154122018-02-21 Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public van der Aa, Maartje J. Paulus, Aggie T. G. Hiligsmann, Mickaël J. C. Maarse, Johannes A. M. Evers, Silvia M. A. A. Inquiry Original Research In Europe, health insurance arrangements are under reform. These arrangements redistribute collectively financed resources to ensure access to health care for all. Allocation of health services is historically based on medical needs, but use of other criteria, such as lifestyle, is debated upon. Does the general public also have preferences for conditional allocation? This depends on their opinions regarding deservingness. The aim of this study was to gain insight in those opinions, specifically by examining the perceived weight of different criteria in allocation decisions. Based on literature and expert interviews, we included 5 criteria in a discrete choice experiment: need, financial capacity, lifestyle, cooperation with treatment, and package/premium choice. A representative sample of the Dutch population was invited to participate (n = 10 760). A total of 774 people accessed the questionnaire (7.2%), of whom 375 completed it (48.4%). Medical need was overall the most important criterion in determining deservingness (range β = 1.60). Perceived deservingness decreased if claimants had higher financial capacity (1.26) and unhealthier lifestyle (1.04), if their cooperation was less optimal (1.05), or if they had opted for less insurance coverage (0.56). However, preferences vary among respondents, in relation to demographic and ideological factors. SAGE Publications 2018-02-14 /pmc/articles/PMC5815412/ /pubmed/29442532 http://dx.doi.org/10.1177/0046958017751981 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
van der Aa, Maartje J.
Paulus, Aggie T. G.
Hiligsmann, Mickaël J. C.
Maarse, Johannes A. M.
Evers, Silvia M. A. A.
Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title_full Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title_fullStr Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title_full_unstemmed Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title_short Varying Opinions on Who Deserves Collectively Financed Health Care Services: A Discrete Choice Experiment on Allocation Preferences of the General Public
title_sort varying opinions on who deserves collectively financed health care services: a discrete choice experiment on allocation preferences of the general public
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815412/
https://www.ncbi.nlm.nih.gov/pubmed/29442532
http://dx.doi.org/10.1177/0046958017751981
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