Bedside Rationing Under Resource Constraints-A National Survey of Ethiopian Physicians' Use of Criteria for Priority Setting

Overview

Journal AJOB Empir Bioeth

Specialties General Medicine
Medical Ethics

Date 2019 Apr 20

PMID 31002289

Citations 4

Authors

Frehiwot Berhane Defaye

Marion Danis

Paul Wakim

Yemane Berhane

Ole Frithjof Norheim

Ingrid Miljeteig

Affiliations

Soon will be listed here.

Abstract

In low-income settings resource constraints force clinicians to make harsh choices. We examine the criteria Ethiopian physicians use in their bedside rationing decisions through a national survey at 49 public hospitals in Ethiopia. Substantial variation in weight given to different criteria were reported by the 587 participating physicians (response rate 91.7%). Young age, primary prevention, or the patient being the family's economic provider increased likelihood of offering treatment to a patient, while small expected benefit or low chance of success diminished likelihood. More than 50% of responding physicians were indifferent to patient's position in society, unhealthy behavior, and residence, while they varied widely in weight they gave to patient's poverty, ability to work, and old age. While the majority of Ethiopian physicians reported allocation of resources that was compatible with national priorities, more contested criteria were also frequently reported. This might affect distributional justice and equity in health care access.

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