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Physicians' views on resource availability and equity in four European health care systems

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Hurst, Samia A., Forde, Reidun, Reiter-Theil, Stella, Slowther, Anne, Perrier, Arnaud, Pegoraro, Renzo and Danis, Marion (2007) Physicians' views on resource availability and equity in four European health care systems. BMC Health Services Research, 7 (1). pp. 1-11. 137. doi:10.1186/1472-6963-7-137

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Official URL: http://dx.doi.org/10.1186/1472-6963-7-137

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Abstract

Background:
In response to limited resources, health care systems have adopted diverse cost-containment strategies and give priority to differing types of interventions. The perception of physicians, who witness the effects of these strategies, may provide useful insights regarding the impact of system-wide priority setting on access to care.

Methods:
We conducted a cross-sectional survey to ascertain generalist physicians' perspectives on resources allocation and its consequences in Norway, Switzerland, Italy and the UK.

Results:
Survey respondents (N = 656, response rate 43%) ranged in age from 28-82, and averaged 25 years in practice. Most respondents (87.7%) perceived some resources as scarce, with the most restrictive being: access to nursing home, mental health services, referral to a specialist, and rehabilitation for stroke. Respondents attributed adverse outcomes to scarcity, and some respondents had encountered severe adverse events such as death or permanent disability. Despite universal coverage, 45.6% of respondents reported instances of underinsurance. Most respondents (78.7%) also reported some patient groups as more likely than others to be denied beneficial care on the basis of cost. Almost all respondents (97.3%) found at least one cost-containment policy acceptable. The types of policies preferred suggest that respondents are willing to participate in cost-containment, and do not want to be guided by administrative rules (11.2%) or restrictions on hospital beds (10.7%).

Conclusion:
Physician reports can provide an indication of how organizational factors may affect availability and equity of health care services. Physicians are willing to participate in cost-containment decisions, rather than be guided by administrative rules. Tools should be developed to enable physicians, who are in a unique position to observe unequal access or discrimination in their health care environment, to address these issues in a more targeted way.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Health care rationing
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed central
ISSN: 1472-6963
Official Date: 31 August 2007
Dates:
DateEvent
31 August 2007Published
31 August 2007Accepted
4 December 2006Submitted
Volume: 7
Number: 1
Number of Pages: 11
Page Range: pp. 1-11
Article Number: 137
DOI: 10.1186/1472-6963-7-137
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: National Institutes of Health (U.S.). Department of Clinical Bioethics (NIH), Hôpitaux universitaires de Genève [University Hospitals of Geneva], Oltramare Foundation, Centre lémanique d'éthique‏, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung [Swiss National Science Foundation] (SNSF)

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