IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0019222.html
   My bibliography  Save this article

Health Systems and Sustainability: Doctors and Consumers Differ on Threats and Solutions

Author

Listed:
  • Jane Robertson
  • Emily J Walkom
  • David A Henry

Abstract

Background: Healthcare systems face the problem of insufficient resources to meet the needs of ageing populations and increasing demands for access to new treatments. It is unclear whether doctors and consumers agree on the main challenges to health system sustainability. Methodology: We conducted a mail survey of Australian doctors (specialists and general practitioners) and a computer assisted telephone interview (CATI) of consumers to determine their views on contributors to increasing health care costs, rationing of services and involvement in health resource allocation decisions. Differences in responses are reported as odds ratios (OR) and 99% confidence intervals (CI). Results: Of 2948 doctors, 1139 (38.6%) responded; 533 of 826 consumers responded (64.5% response). Doctors were more concerned than consumers with the effects of an ageing population (OR 3.0; 99% CI 1.7, 5.4), and costs of new drugs and technologies (OR 5.1; CI 3.3, 8.0), but less likely to consider pharmaceutical promotional activities as a cost driver (OR 0.29, CI 0.22, 0.39). Doctors were more likely than consumers to view ‘community demand’ for new technologies as a major cost driver, (OR 1.6; 1.2, 2.2), but less likely to attribute increased costs to patients failing to take responsibility for their own health (OR 0.35; 0.24, 0.49). Like doctors, the majority of consumers saw a need for public consultation in decisions about funding for new treatments. Conclusions: Australian doctors and consumers hold different views on the sustainability of the healthcare system, and a number of key issues relating to costs, cost drivers, roles and responsibilities. Doctors recognise their dual responsibility to patients and society, see an important role for physicians in influencing resource allocation, and acknowledge their lack of skills in assessing treatments of marginal value. Consumers recognise cost pressures on the health system, but express willingness to be involved in health care decision making.

Suggested Citation

  • Jane Robertson & Emily J Walkom & David A Henry, 2011. "Health Systems and Sustainability: Doctors and Consumers Differ on Threats and Solutions," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-9, April.
    • Handle: RePEc:plo:pone00:0019222
    DOI: 10.1371/journal.pone.0019222
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0019222
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0019222&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0019222?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wiseman, V. & Mooney, G. & Berry, G. & Tang, K. C., 2003. "Involving the general public in priority setting: experiences from Australia," Social Science & Medicine, Elsevier, vol. 56(5), pages 1001-1012, March.
    2. Jones, Ian Rees & Berney, Lee & Kelly, Moira & Doyal, Len & Griffiths, Chris & Feder, Gene & Hillier, Sheila & Rowlands, Gillian & Curtis, Sarah, 2004. "Is patient involvement possible when decisions involve scarce resources? A qualitative study of decision-making in primary care," Social Science & Medicine, Elsevier, vol. 59(1), pages 93-102, July.
    3. Litva, Andrea & Coast, Joanna & Donovan, Jenny & Eyles, John & Shepherd, Michael & Tacchi, Jo & Abelson, Julia & Morgan, Kieran, 2002. "'The public is too subjective': public involvement at different levels of health-care decision making," Social Science & Medicine, Elsevier, vol. 54(12), pages 1825-1837, June.
    4. Owen-Smith, Amanda & Coast, Joanna & Donovan, Jenny, 2009. ""I can see where they're coming from, but when you're on the end of it ... you just want to get the money and the drug.": Explaining reactions to explicit healthcare rationing," Social Science & Medicine, Elsevier, vol. 68(11), pages 1935-1942, June.
    5. Ayres, Philip J., 1996. "Rationing health care: Views from general practice," Social Science & Medicine, Elsevier, vol. 42(7), pages 1021-1025, April.
    6. Coast, Joanna & Donovan, Jenny & Litva, Andrea & Eyles, John & Morgan, Kieran & Shepherd, Michael & Tacchi, Jo, 2002. ""If there were a war tomorrow, we'd find the money": contrasting perspectives on the rationing of health care," Social Science & Medicine, Elsevier, vol. 54(12), pages 1839-1851, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jane Robertson & David A Newby & Emily J Walkom, 2016. "Health Care Spending: Changes in the Perceptions of the Australian Public," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-12, June.
    2. Fabrizio Russo, 2016. "What is the CSR’s Focus in Healthcare?," Journal of Business Ethics, Springer, vol. 134(2), pages 323-334, March.
    3. Gill, Betty & Griffin, Barbara & Hesketh, Beryl, 2013. "Changing expectations concerning life-extending treatment: The relevance of opportunity cost," Social Science & Medicine, Elsevier, vol. 85(C), pages 66-73.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Thurston, Wilfreda E. & MacKean, Gail & Vollman, Ardene & Casebeer, Ann & Weber, Myron & Maloff, Bretta & Bader, Judy, 2005. "Public participation in regional health policy: a theoretical framework," Health Policy, Elsevier, vol. 73(3), pages 237-252, September.
    2. Broqvist, Mari & Garpenby, Peter, 2015. "It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing," Social Science & Medicine, Elsevier, vol. 128(C), pages 301-308.
    3. Rosenberg-Yunger, Zahava R.S. & Thorsteinsdóttir, Halla & Daar, Abdallah S. & Martin, Douglas K., 2012. "Stakeholder involvement in expensive drug recommendation decisions: An international perspective," Health Policy, Elsevier, vol. 105(2), pages 226-235.
    4. Russell, Jill & Greenhalgh, Trisha, 2012. "Affordability as a discursive accomplishment in a changing National Health Service," Social Science & Medicine, Elsevier, vol. 75(12), pages 2463-2471.
    5. van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
    6. Owen-Smith, Amanda & Donovan, Jenny & Coast, Joanna, 2015. "How clinical rationing works in practice: A case study of morbid obesity surgery," Social Science & Medicine, Elsevier, vol. 147(C), pages 288-295.
    7. Darker, Catherine D. & Donnelly-Swift, Erica & Whiston, Lucy, 2018. "Demographic factors and attitudes that influence the support of the general public for the introduction of universal healthcare in Ireland: A national survey," Health Policy, Elsevier, vol. 122(2), pages 147-156.
    8. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    9. Li, Kathy K. & Abelson, Julia & Giacomini, Mita & Contandriopoulos, Damien, 2015. "Conceptualizing the use of public involvement in health policy decision-making," Social Science & Medicine, Elsevier, vol. 138(C), pages 14-21.
    10. Llanwarne, Nadia & Newbould, Jennifer & Burt, Jenni & Campbell, John L. & Roland, Martin, 2017. "Wasting the doctor's time? A video-elicitation interview study with patients in primary care," Social Science & Medicine, Elsevier, vol. 176(C), pages 113-122.
    11. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    12. Benning, Tim M. & Dellaert, Benedict G.C., 2013. "Paying more for faster care? Individuals' attitude toward price-based priority access in health care," Social Science & Medicine, Elsevier, vol. 84(C), pages 119-128.
    13. Lea de Jong & Jan Zeidler & Kathrin Damm, 2022. "A systematic review to identify the use of stated preference research in the field of older adult care," European Journal of Ageing, Springer, vol. 19(4), pages 1005-1056, December.
    14. Pivik, Jayne & Rode, Elisabeth & Ward, Christopher, 2004. "A consumer involvement model for health technology assessment in Canada," Health Policy, Elsevier, vol. 69(2), pages 253-268, August.
    15. Malfait, S. & Van Hecke, A. & De Bodt, G. & Palsterman, N. & Eeckloo, K., 2018. "Patient and public involvement in hospital policy-making: Identifying key elements for effective participation," Health Policy, Elsevier, vol. 122(4), pages 380-388.
    16. O'Meara, Wendy Prudhomme & Tsofa, Benjamin & Molyneux, Sassy & Goodman, Catherine & McKenzie, F. Ellis, 2011. "Community and facility-level engagement in planning and budgeting for the government health sector - A district perspective from Kenya," Health Policy, Elsevier, vol. 99(3), pages 234-243, March.
    17. Abelson, Julia & Forest, Pierre-Gerlier & Eyles, John & Casebeer, Ann & Martin, Elisabeth & Mackean, Gail, 2007. "Examining the role of context in the implementation of a deliberative public participation experiment: Results from a Canadian comparative study," Social Science & Medicine, Elsevier, vol. 64(10), pages 2115-2128, May.
    18. Abelson, Julia & Giacomini, Mita & Lehoux, Pascale & Gauvin, Francois-Pierre, 2007. "Bringing `the public' into health technology assessment and coverage policy decisions: From principles to practice," Health Policy, Elsevier, vol. 82(1), pages 37-50, June.
    19. Degeling, Chris & Carter, Stacy M. & Rychetnik, Lucie, 2015. "Which public and why deliberate? – A scoping review of public deliberation in public health and health policy research," Social Science & Medicine, Elsevier, vol. 131(C), pages 114-121.
    20. Jolanki, Outi & Tynkkynen, Liina-Kaisa, 2018. "Primary health care nurses’ views on patients’ abilities and resources to make choices and take decisions on health care," Health Policy, Elsevier, vol. 122(9), pages 957-962.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0019222. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.