Objective Several studies have analyzed allocation strategies among different society groups based on 9 allocation principles; sickest-first, waiting list, prognosis, youngest-first, instrumental values, lottery, monetary contribution, reciprocity and individual behavior. Sometimes combinations, youngest-first and prognosis for example, can be considered. Our aim was to study the most important prioritization principles groups in Jordan.
Methods An online survey handling 3 situations of medical scarcity; (1) organ donation, (2) limited hospital beds during influenza epidemic, and (3) allocation of novel therapeutics for lung cancer, and a free comment option constituted the survey.
Results Seven hundreds and fifty-four responses were analyzed from five groups including religion scholars, physicians, medical students, health allied practitioners and lay people. The most important priority principle was ‘Sickest-First’ for the three scenarios among the surveyed groups, except for physicians in the first scenario where ‘Sickest-First’ and ‘Combination-criteria’ were of equal importance. In general, there were no differences between the examined groups compared to lay people in the preference of options for all scenarios, however physicians were more likely to choose the ‘Combination-criteria’ in both the second and third scenarios (OR 3.70, 95% CI = 1.62-8.44, and 2.62, 95% CI = 1.48-4.59; p-value = 0.00, 0.00 respectively), and were less likely to choose the ‘sickest-first’ as the single most important priority principle (OR 0.57, CI = 0.37-0.88, and 0.57; 95% CI=0.36-0.88; p-value = 0.01, 0.01 respectively). Out of 100 free-comments, 27 (27.0%) thought the ‘social-value’ of the patients should be considered, adding the 10th potential allocation principle.
Conclusion Our findings are concordant with literature in terms of allocating scarce medical resources. However, ‘social-value’ should be addressed when prioritizing scarce medical resources in Jordan, and probably other LMICs.
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