Fair reckoning: a qualitative investigation of responses to an economic health resource allocation survey.

Objective To investigate how participants in an economic resource allocation survey construct notions of fairness. Design Qualitative interview study guided by interpretive grounded theory methods. Setting and participants Qualitative interviews were conducted with volunteer university- ( n = 39) an...

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Publicado en:Health Expectations Vol. 17; no. 3; pp. 174 - 186
Autores principales: Giacomini, Mita, Hurley, Jeremiah, DeJean, Deirdre
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2014
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Fair reckoning: a qualitative investigation of responses to an economic health resource allocation survey.
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        au:
          Giacomini, Mita
          Hurley, Jeremiah
          DeJean, Deirdre
        affil: Professor, Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics & Policy Analysis, McMaster University, Hamilton, ON
      sug:
        subj:
          Health Resource Allocation Evaluation
          Health Resource Allocation Economics
          Funding Source
          Human
          Qualitative Studies
          Interviews
          Grounded Theory
          Descriptive Statistics
          Surveys
          Ontario
          Audiorecording
      ab: Objective To investigate how participants in an economic resource allocation survey construct notions of fairness. Design Qualitative interview study guided by interpretive grounded theory methods. Setting and participants Qualitative interviews were conducted with volunteer university- ( n = 39) and community-based ( n = 7) economic survey participants. Intervention or main variables studied We explored how participants constructed meanings to guide or explain fair survey choices, focusing on rationales, imagery and additional desired information not provided in the survey scenarios. Main outcome measures Data were transcribed and coded into qualitative categories. Analysis iterated with data collection iterated through three waves of interviews. Results Participants compared the survey dilemmas to domains outside the health system. Most compared them with other micro-level, inter-personal sharing tasks. Participants raised several fairness-relevant factors beyond need or capacity to benefit. These included age, weight, poverty, access to other options and personal responsibility for illness; illness duration, curability or seriousness; life expectancy; possibilities for sharing; awareness of other's needs; and ability to explain allocations to those affected. They also articulated a fairness principle little considered by equity theories: that everybody must get something and nobody should get nothing. Discussion and conclusions Lay criteria for judging fairness are myriad. Simple scenarios may be used to investigate lay commitments to abstract principles. Although principles are the focus of analysis and inference, participants may solve simplified dilemmas by imputing extraneous features to the problem or applying unanticipated principles. These possibilities should be taken into account in the design of resource allocation surveys eliciting the views of the public.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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