Us neurologists : Attitudes on rationing

Us neurologists : Attitudes on rationing

To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is cur...

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Bibliographic Details
Published in:Neurology Vol. 55; no. 10; pp. 1492 - 1497
Main Authors: HOLLOWAY, R. G, RINGEL, S. P, BERNAT, J. L, KERAN, C. M, LAWYER, B. L
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins 28-11-2000
Subjects:
Attitude of Health Personnel
Bioethics
Biological and medical sciences
Cost-Benefit Analysis
Data Collection
Health Care Rationing - economics
Health participants
Humans
Medical sciences
Neurology
Public health. Hygiene
Public health. Hygiene-occupational medicine
United States
United States
Human
Neurology
Rationing
Physician
Public health
Care
Cost efficiency analysis
Empirical Approach
American Academy of Neurology
Health Care and Public Health
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Summary:To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is currently being underused in resource allocation decisions. The authors surveyed a random sample of neurologists practicing in the United States (response rate, 44.4%) with three hypothetical scenarios. Two scenarios were designed to address general attitudes on allocating finite resources with emphasis on formulary decisions for costly drugs. The third scenario was designed to assess whether neurologists would optimize the allocation of a fixed budget as recommended by cost-effectiveness analysis. Three-quarters of respondents thought that neurologists make daily decisions that effectively ration healthcare resources, and 60% felt a professional responsibility to consider the financial impact of individualized treatment decisions on other patients. Only 25% of respondents thought that there should be no restrictions placed on any of the five newer antiepileptic agents. In a 1995 survey, 75% of similarly sampled neurologists agreed that no restrictions should be placed on the availability of FDA-approved medications. Nearly half (46%) of respondents favored a less effective test and would be willing to let patients die to ensure the offering of a more equitable alternative. Most neurologists recognize the need to ration health care, and although they think cost-effectiveness research is one method to achieve efficient distribution of resources, many think that considerable attention should also be given to equity.
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ISSN:0028-3878
1526-632X
DOI:10.1212/WNL.55.10.1492