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Bedsides healthcare rationing dilemmas: A survey from Bulgaria and comparison with Portugal

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Abstract

We investigate the views of Bulgarian citizens on the principles that should guide microallocation healthcare resources and compare them directly with those of Portuguese citizens. A self-administered online questionnaire was used to collect data from a sample of 298 Bulgarian citizens, using methods from a matching previous study in Portugal. Respondents faced a hypothetical rationing exercise where they had to choose and order four patients (differentiated by personal and health characteristics) and a set of statements that embodied: (i) distributive criteria for prioritizing patients, (ii) who should prioritize patients, and (iii) the likelihood of these prioritization decisions being real. Descriptive statistics, factor analysis, and non-parametric test were used. Findings suggest that Bulgarian respondents: (i) support a plurality of distributive principles to underpin healthcare priority setting with an incident on the severity of health conditions, on utilitarianism and on reducing health inequalities; (ii) trust in the health professional to make prioritization decisions and (iii) do not seem to believe that patients' prioritization will ever become real. While Bulgarian and Portuguese respondents support a number of shared ethical principles they place a different level of importance to each. Bulgarians value mainly the age criterion in prioritizing patients, whereas Portuguese revealed a greater concern about efficiency.

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Acknowledgment

We would like to thank Anna-Maria Vilamovska for helping in collecting the data.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Portucalense Institute for Legal Reseach (IJP), DEGI, Portucalense University, Rua Dr. Bernardino de Almeida 541, 4200-072, Porto, Portugal

    Micaela Pinho

  2. Research Unit in Governance, Competitiveness and Public Policies (GOVCOPP), DEGEIT, University of Aveiro, Aveiro, Portugal

    Micaela Pinho

  3. ISAG Research Unit – European Business School, Campus de Salazares/Ramalde, Rua Salazares 842, 4100-442, Porto, Portugal

    Ana Pinto Borges

  4. Lusíada University of North, Porto, Portugal

    Ana Pinto Borges

  5. Open Society Institute, 56 Solunska Str., 1000, Sofia, Bulgaria

    Boyan Zahariev

Authors
  1. Micaela Pinho
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  2. Ana Pinto Borges
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  3. Boyan Zahariev
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Correspondence to Micaela Pinho.

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Pinho, M., Borges, A.P. & Zahariev, B. Bedsides healthcare rationing dilemmas: A survey from Bulgaria and comparison with Portugal. Soc Theory Health 15, 285–301 (2017). https://doi.org/10.1057/s41285-017-0029-2

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  • DOI: https://doi.org/10.1057/s41285-017-0029-2

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