Priority-Setting and Personality: Effects of Dispositional Optimism on Preferences for Allocating Healthcare Resources

  • Jeroen LuytenEmail author
  • Roselinde Kessels
  • Pieter Desmet
  • Peter Goos
  • Philippe Beutels


In a publicly financed health system, it is important that priority-setting reflects social values. Many studies investigate public preferences through surveys taken from samples, but to be representative, these samples must reflect value judgments of all relevant population subgroups. In this study, we explore whether, next to better-understood sources of heterogeneity such as age, education or gender, also differences in personality play a role in how people want to set limits to health care. We investigate the influence of dispositional optimism: whether someone anticipates a good or bad future. This is an important personality dimension that has been shown to widely reverberate into people’s lives and that can also be expected to influence people’s views on health care. To test our hypothesis, we asked a representative sample of the Belgian population (N = 750) to complete both the revised life orientation test and a discrete choice experiment about allocating healthcare resources, and we investigated the relationships between both measurements. We found that more pessimistic individuals were less supportive of using patients’ age as a selection criterion and more hesitant to invest in prevention. Since individual dispositions are usually not part of the criteria for selecting representative samples, our findings point at a potential non-response bias in studies that elicit social values.


Resource allocation Preferences Equity Prevention Fair innings Responsibility Optimism Pessimism 



We are grateful to Dr. Michael Shiner and two anonymous reviewers for their comments on an earlier version of this manuscript.

Authors’ Contributions

JL, PD and PB framed the research question and set up the experiment. RK and PG designed the experiment. RK and JL analysed the data. All authors were involved in the writing of the text.


The authors acknowledge funding from the Research Foundation—Flanders (FWO, Project Numbers G098911N and G043815N, and Roselinde Kessels’ postdoctoral fellowship) and Pfizer’s European HTAcademy prize competition (2011) and the Antwerp Study Centre for Infectious Diseases (ASCID) at the University of Antwerp. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical Standards

The Committee for Medical Ethics of the University of Antwerp reviewed the study protocol, the questionnaire and the information letter for participants and approved them on 16 March 2015. The market research company Ipsos conducted the survey and provided the responses for analysis in anonymous form only.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Leuven Institute for Healthcare PolicyKU LeuvenLouvainBelgium
  2. 2.Faculty of Business and EconomicsUniversity of AntwerpAntwerpBelgium
  3. 3.School of EconomicsUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Rotterdam Institute for Law and EconomicsErasmus University RotterdamRotterdamThe Netherlands
  5. 5.Department of Biosystems, Faculty of Bioscience EngineeringUniversity of LeuvenLouvainBelgium
  6. 6.Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  7. 7.School of Public Health and Community MedicineThe University of New South WalesSydneyAustralia

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