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Public Preferences in Priority Setting when Admitting Patients to the ICU During the COVID-19 Crisis: A Pilot Study

Author

Listed:
  • Merle Gijsbers

    (University of Twente)

  • Iris Elise Keizer

    (University of Twente)

  • Stephanie Else Schouten

    (University of Twente)

  • Janneke Louise Trompert

    (University of Twente)

  • Catharina G. M. Groothuis-Oudshoorn

    (University of Twente)

  • Janine Astrid Til

    (University of Twente)

Abstract

Introduction One of the challenges faced by hospitals during the coronavirus disease 2019 (COVID-19) pandemic is resource shortages in intensive care units (ICUs). In times of scarcity, patient prioritization based on non-medical considerations might be necessary. Objective The aim of this study was to pilot test a survey to elicit public opinions on the relative importance of non-medical considerations in priority setting when admitting patients to the ICU in times of crisis. Methods A discrete-choice experiment was used to collect social preferences for priority setting when admitting patients to the ICU during the COVID-19 pandemic. The six attributes were patient age, profession, guardianship, risk-conscious behavior on a societal level, health-conscious behavior, and expected ICU length of stay. The data were analyzed using a mixed multinomial logit model. Interactions between the age and profession of the respondents and the age and profession of the patient profiles were considered. Results The mean (± standard deviation) age of respondents was 35.9 ± 14.5 years. In all, 70% of respondents indicated that medical and/or non-medical considerations should play a role in prioritizing patients for the ICU, whereas 15% agreed with a “first come, first served” strategy and the remaining 15% had no opinion. Respondents deemed risk-conscious behavior on a societal level to be the most important non-medical factor that should be used to prioritize patients in phase three of the framework, garnering an attribute importance (AI) of 31.2%, followed by patient age (AI 16.3%) and health-conscious behavior (AI 16.0%). ICU length of stay had the lowest impact on patient prioritization for ICU admittance (AI 10.9%). Younger and older respondents attached more importance to age than respondents in the middle age group and indicated a stronger preference to prioritize patients in their own age group (p = 0.042). Conclusion The results of our study demonstrate the relative importance members of the public attach to responsible societal behavior during the COVID-19 pandemic. In the next phase of the study, we will elicit the perspectives of a representative sample of the Dutch population. Changes to the task design and attribute operationalization could improve the external validity of the study findings, and optimization of the experimental design will improve the internal validity of the study.

Suggested Citation

  • Merle Gijsbers & Iris Elise Keizer & Stephanie Else Schouten & Janneke Louise Trompert & Catharina G. M. Groothuis-Oudshoorn & Janine Astrid Til, 2021. "Public Preferences in Priority Setting when Admitting Patients to the ICU During the COVID-19 Crisis: A Pilot Study," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(3), pages 331-338, May.
    • Handle: RePEc:spr:patien:v:14:y:2021:i:3:d:10.1007_s40271-021-00504-4
    DOI: 10.1007/s40271-021-00504-4
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    References listed on IDEAS

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    1. Aizaki, Hideo, 2012. "Basic Functions for Supporting an Implementation of Choice Experiments in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 50(c02).
    2. Caroline Vass & Dan Rigby & Katherine Payne, 2017. "The Role of Qualitative Research Methods in Discrete Choice Experiments," Medical Decision Making, , vol. 37(3), pages 298-313, April.
    3. Ilene L. Hollin & Benjamin M. Craig & Joanna Coast & Kathleen Beusterien & Caroline Vass & Rachael DiSantostefano & Holly Peay, 2020. "Reporting Formative Qualitative Research to Support the Development of Quantitative Preference Study Protocols and Corresponding Survey Instruments: Guidelines for Authors and Reviewers," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(1), pages 121-136, February.
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    1. Rachael L. DiSantostefano & Fern Terris-Prestholt, 2021. "Using Societal Values to Inform Public Health Policy During the COVID-19 Pandemic: The Role of Health Preference Research," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(3), pages 303-307, May.
    2. Haghani, Milad & Bliemer, Michiel C.J. & de Bekker-Grob, Esther W., 2022. "Applications of discrete choice experiments in COVID-19 research: Disparity in survey qualities between health and transport fields," Journal of choice modelling, Elsevier, vol. 44(C).

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