Will Elderly Patients Stand Aside for Younger Patients in the Queue for Cardiac Services?
De Leo, Diego
Dello Buono, Marirosa
Naylor, C. David
Lancet. 1999 Aug 7; 354(9177): 467-470.
BACKGROUND: Fair management of queues for hospital-based services requires consideration of clinical need, but there is no information on public attitudes towards non-clinical factors such as age or work status as determinants of priority. METHODS: We asked elderly residents of Padova, Italy, whether, if they were awaiting cardiac surgery or an outpatient cardiology consultant, they would give up their place in line for a younger or self-employed individual. We also elicited responses from a convenience sample of younger health workers asked to imagine themselves as elderly persons facing the same choices. FINDINGS: The eligible response rate was 72% (443/616). About half deemed it right to give up their place in line for cardiac surgery to a 45-year-old (51%, 95% CI 46-56) or self-employed person (47%, 95% CI 42-51) Proportions were significantly higher for an outpatient consultation (68%, 95% CI 63-72). In multivariate analyses, married respondents, those closer to age 65, university graduates, and those who were formerly self-employed were significantly less likely to respond affirmatively. In significant contrast for all four scenarios (p less than 0.0001), the overwhelming majority of non-elderly respondents refused to give up their places in line. INTERPRETATION: The majority of elderly citizens were hypothetically willing to cede priority in accessing cardiac care to younger or self-employed persons, but this willingness was attenuated among the "young" elderly and more privileged respondents. Non-elderly respondents were much less self-sacrificing, suggesting that ageing baby-boomers may be more assertive about their continuing rights to health care.
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Mariotto, Aldo; De Leo, Diego; Dello Buono, Marirosa; Favaretti, Carlo; Austin, Peter; Naylor, C. David (1999-08-07)
Effects of Socioeconomic Status on Access to Invasive Cardiac Procedures and on Mortality After Acute Myocardial Infarction Alter, David A.; Naylor, C. David; Austin, Peter; Tu, Jack V. (1999-10-28)
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