Prioritization, Incentives, and Resource Use for Sustainable Dentistry: The EU PRUDENT Project

KNOWLEDGE TRANSFER STATEMENT

The EU PRUDENT project aims to enhance the financing of oral health systems through novel evidence and implementation of better financing solutions together with citizens, patients, providers, and policy makers. The multicountry nature of the project offers unique windows of opportunity for rapid learning and improving within and across various contexts. PRUDENT is anticipated to strengthen capacities for better oral care financing in the EU and worldwide.

Digital Transformation and Local Government Response to the COVID-19 Pandemic: An Assessment of Its Impact on the Sustainable Development Goals

This paper analyzes how Digital Transformation (DT) processes have influenced the Attitude of local governments (LGs) toward the COVID-19 pandemic and their effect on achieving the United Nations' Sustainable Development Goals (SDGs). The data were collected from LGs in Spain (n = 124) through a questionnaire in which the IT skills of their workers, the DT processes, budgets, degree of regulatory compliance, and implementation of trust seals were measured, together with the IT security measures adopted. The contrast between the proposed model and the results showed that the direct influence of IT security influences the government's attitude toward COVID-19 and DT implementing actions to achieve SDGs. The findings of this work are of great value both for the actors involved in the design and implementation of public policies and for those responsible for local governance in their objective to improve citizens' experience of the services provided and in exceptional situations such as the one experienced as a result, of-COVID-19.

Opinions of citizens of the Czech Republic on the role of nurses in primary care during the COVID-19 pandemic

INTRODUCTION AND OBJECTIVE

In spite of the general current decrease in COVID-19 incidence, the epidemiological situation on the territory of the Czech Republic is still unfavourable. Nurses play an essential role in the fight against this disease.

MATERIAL AND METHODS

A non-standardized questionnaire was used to discover the expectations regarding nursing care provided during the COVID-19 pandemic. The sample of respondents was constructed using quota selection. The sample consisted of 1,815 respondents.

RESULTS

The study identified a significant correlation between the age of respondents and the method used to contact general practitioners (p < 0.001). The oldest respondents (65+) more likely contacted GPs by phone. Respondents with basic education used outpatient services more often before than during the pandemic (p < 0.05). The behaviour of nurses was considered as professional and accommodating. The oldest respondents (65+) reported nurses did not to make them feel rushed. Other age groups rated nurses more critically (p < 0.01). Respondents, especially women, described the psychological burden on nurses during the COVID-19 pandemic as demanding (p < 0.01). Women, more than men, reported that nurses lacked protective equipment during the pandemic (p < 0.05). The use of an online system was significantly influenced by respondent education (p 0.001). Respondents with lower education were less likely to welcome this option.

CONCLUSIONS

Due to the persisting COVID-19 incidence on the territory of the Czech Republic, citizens` opinions of the position of nurse in primary care in the period of COVID- 19 pandemics need to be known.The behaviour of nurses was considered to be accommodating and satisfactory.

One Health for Headaches: A Clinical Scientist Residence Project

Headaches are non-communicable diseases and have a well-perceived stigma and the greatest personal, biopsychosocial, and occupational burden. The focus of biomedical research has brought attention to certain aspects, such as occupational, educational, and health organization impacts, favoring aspects of therapeutic innovation. These aspects are viable in countries with a high gross domestic product but are less so in countries with a low or average level of development, where dedicated health infrastructures, advanced drugs, and even disease awareness and basic education are lacking. Here, we propose the idea of a One Health project that includes headaches, where the patient is not seen as a single unit but as a high user of public health facilities, a low-efficiency worker, and a citizen with a clear social stigma. This hypothesis of the development of a self-assessment tool is based on seven domains, whose results will be offered for validation and evaluation to stakeholders, scientific societies, research groups, and key opinion leaders, in order to provide a framework of the specific needs per area of intervention (awareness, research, and education, etc.), per geographical area.

Development of the Training Program on Child Abuse Prevention for Citizens (TCAP-C) and Its Effects and Acceptability: Community-Based Participatory Research

AIM

We developed the Training Program on Child Abuse Prevention for Citizens (TCAP-C) and tested its effects and acceptability among citizen leaders (CLs).

METHODS

Community-based participatory research using a pretest-posttest follow-up design was conducted in Tokyo, Japan from September 2021 to March 2022. Participants completed questionnaires before, upon completion, and one month and three months after TCAP-C. Recognition, knowledge, and behaviors regarding child abuse and community consciousness were collected and compared before and one and three months after TCAP-C, and the degree of satisfaction, understanding, and meaningfulness were collected upon completion. We analyzed data using repeated-measures ANCOVA.

RESULTS

A total of 111, 98, 101, and 94 participants completed the questionnaires before, upon completion, and one and three months after TCAP-C, respectively. Overall, the recognition, knowledge, and community consciousness scores significantly improved from before to one month and three months after TCAP-C. Regarding the behaviors, only the behaviors of learning and watching over were significantly improved from before to one month after TCAP-C; however, those behaviors were not different between before and three months after TCAP-C. Furthermore, 95% participants reported being entirely satisfied with TCAP-C, and 85% and 91% reported good understanding and meaningfulness of the program.

CONCLUSIONS

TCAP-C is acceptable and can improve CL recognition, knowledge, and community consciousness.

Relationship between citizens' perspective on digital health and underlying health risks

Objective

Digital health has been gaining widespread attention but has not been fully integrated into the existing healthcare system. However, it remains unclear whether the new digital health solutions align with users' needs and wants. This study examines how citizens perceive the functionalities of digital health and how different health risks influence their perception.

Methods

Using an online survey, data are collected from over 4000 Danish citizens. The data are analysed using linear regression models.

Results

The results show how users' perceptions of digital health differ significantly. Users are highly interested in data sharing across different healthcare stakeholders but less interested in online health communities. The results also show that the support for digital health is correlated with various health risks, including age, smoking and social network. However, health risks do not have uniform relationship with the perceived value of digital health.

Conclusions

While developing and implementing new digital health solutions, it is important to consider the perceptions of people who are expected to benefit from such solutions. This study contributes to the literature by deepening the knowledge of how citizens with different risk profiles perceive the multitude of digital health tools being introduced in the healthcare sector.

The process of Transformative Learning in Dialog Café with Health Professionals and Citizens/Patients

INTRODUCTION

Dialogue Café, which is an inclusive process that provides a platform for the exchange of ideas or perspectives on certain issues, is a suitable approach to facilitating mutual understanding between health professionals and citizens/patients. However, little is known about the effects of the Dialogue Café on participants in the context of health communication. Previous studies suggest that transformative learning occurs after dialogue.

OBJECTIVES

This study aimed to clarify the process of the transformative learning process among participants of the Dialog Café and to evaluate whether their transformative learning would lead to an understanding of others' perspectives.

METHODS

We conducted a psychometric analysis of a web-based questionnaire consisting of 72 items for participants of Dialog Café held from 2011 to 2013 in Tokyo and studied the relationships between various concepts using structural equation modeling (SEM). To evaluate the validity and reliability of concept measurement, we conducted an exploratory factor analysis and a confirmatory factor analysis.

RESULTS

The questionnaire response rate was 39.5% (141/357), of which 80 (56.7%) respondents were health professionals and 61 (43.3%) respondents were citizens/patients. The SEM analysis revealed that transformative learning occurred in both groups. The process of transformative learning consisted of 2 types; one process leading directly to "perspective transformation" and the other leading to "perspective transformation" via "critical self-reflection" and "disorienting dilemmas." "Perspective transformation" was related to "understanding others" in both groups. Among health professionals, "perspective transformation" was related to "transformation of awareness toward patients/users."

CONCLUSION

Dialog Café can facilitate the process of transformative learning among participants, and transformative learning may lead to mutual understanding between health professionals and citizens/patients.

"Who is not an agent here?": The Collateral Damage of Anti-Trafficking in Nepal

In this paper, I explore how the diverse labour migration practices of people who challenge their state's restrictive policies produce a form of stigma that extends from people to the places where they reside. Drawing on the findings of Participatory Action Research (PAR) conducted in Nepal, I demonstrate how people residing in one such place attempt to undo stigma by adopting diverse practices amidst restrictive anti-trafficking and migration policies. I reveal a novel practice of prospective labour migrants negotiating and receiving money from their choicest mobility facilitators to assist their unauthorised labour migration. This exchange of money potentially criminalises prospective labour migrants, their family members, unlicensed and licensed recruitment agents, community leaders, anti-traffickers, government officials, hotel owners, transport service providers, and airport immigration officials as traffickers. Underscoring the collateral damage of anti-trafficking in Nepal, I assert that the exchange of money to facilitate unauthorised migration expands the remit of criminalisation of citizens as "traffickers".

Barriers and Enablers to Food Waste Recycling: A Mixed Methods Study amongst UK Citizens

We aim to identify influences on UK citizens’ household food waste recycling as a basis for designing strategies to increase household food waste collection rates via local services. Using a UK dataset (n = 1801) and the COM-B (Capability–Opportunity–Motivation–Behaviour) model as a theoretical framework, we conduct quantitative regression and supporting thematic analyses to investigate influences on citizens’ recycling of food waste. Results show that automatic motivation (e.g., emotions and habit) and psychological capability (e.g., knowledge) predict household food waste recycling. Physical opportunity (i.e., dealing with food waste in other ways such as home-composting or feeding pets/strays, time and financial costs) was the main barrier to recycling food waste identified in thematic analyses. Participants also reported automatic motivation-related barriers such as concerns over pests, odour, hygiene and local authorities’ food waste collection capabilities. Based on findings we recommend the development of clear, consistent communications aimed at creating positive social norms relating to recycling and increasing knowledge of what can and cannot be put in food waste bins. Improved functional design and free distribution of bins and compostable caddy liners developed according to user-centred needs for cleanliness, convenience and hygiene are also needed. These will not be sufficient without a nationally uniform, efficient and reliable system of household food waste collection.

Citizen Debates in Social Networks about Didactic Resources for Mathematics

Citizens are increasingly turning to social media to open up debates on issues of utmost importance, such as health or education. When analyzing citizens’ social media interactions on COVID-19, research has underlined the importance of sharing and spreading information based on scientific evidence rather than on fake news. However, whether and how citizens’ interactions in the field of education, particularly in mathematics, are based on scientific evidence remains underexplored. To contribute to filling this gap, this article presents an analysis of citizen debates in social networks about didactic resources for mathematics. Through social media analytics, 136,964 posts were extracted from Reddit, Instagram, Twitter and Facebook, of which 1755 were analyzed. Results show that out of the 213 posts of citizen debates on didactic resources for mathematics, only two contained scientific evidence and eight claimed to contain scientific evidence. These findings highlight the importance of promoting actions to encourage citizen debates around didactic resources for mathematics based on scientific evidence.

Factors Affecting Perceived Health Benefits and Use Behaviors in Urban Green Spaces During the COVID-19 Pandemic in Southern China Megacities

Background: The COVID-19 pandemic has alienated people from urban green spaces (UGSs) that have various health outcomes for humans. However, little is known about the influential factors of perceived health benefits and use behaviors in UGSs during the COVID-19 pandemic. This study aims to explore the key factors that influence perceived health benefits and use behaviors in UGSs and to assess the mediating role of place attachment in relationships during the COVID-19 pandemic in Chinese megacities. Methods: We conducted an online questionnaire survey from December 2020 to March 2021 in Guangzhou and Shenzhen, China. Six multiple regression models were constructed to investigate the main factors by which UGSs influence citizens' perceived health benefits and use behaviors. Four mediation models were established using the structural equation modeling (SEM) method to explore the mediating effect of place attachment. Results: A total of 628 questionnaires were included in the analysis. The results revealed that some UGS components (green space access, maintenance, and soundscape) significantly affected perceived health benefits for citizens (physical, mental, and social health) during the COVID-19 pandemic. Conversely, use behaviors (frequency of visits, duration of visits, and activity intensity) were mainly affected by the sociodemographic context but less affected by UGS components. In addition, UGS components were found to significantly predict place attachment, which in turn influenced the perceived health benefits, frequency, and duration of visits. Conclusions: This study distinguished the key factors that affect perceived health benefits and use behaviors during the COVID-19 pandemic: green space access, maintenance, soundscape, and sociodemographic characteristics. Place attachment still needs to be considered when discussing how to encourage citizens to visit UGSs during the pandemic. These findings provide implications for policymakers and landscape planners regarding design and management measures for UGSs that are conducive to coping with pandemics.

A New Tool for an Awareness Plan Concerning Critical Issues, Needs and Attitudes of Citizens on the Use of Medicines

This article describes a pilot study to test the adequacy of a newly developed tool for an awareness plan on the importance of properly using pharmaceuticals. The new tool consists of face-to-face interviews with adult citizens on their approach to the use of medicines and of the following data analysis with a dedicated software application. The pilot study was carried out in a sample area of Sardinia, in Italy. The data from the interviews collected anonymously and analysed in aggregate actually emphasised the critical issues and needs in the use of pharmaceuticals in the sample area involved, also encouraging communication among different actors. The pilot study revealed that the designed tool could represent a novel strategy to stimulate interchanges of information on the proper use of pharmaceuticals with a potential impact on people's health.

A Web Screening on Educational Initiatives to Increase Citizens' Literacy on Genomics and Genetics

Introduction

Population awareness and empowerment in omics sciences represent a fundamental driver to increase the adoption of evidence-based approaches in personalized medicine. In this context, a pivotal role is played by citizens' literacy, and educational initiatives carried out in this context are key assets to drive future effective interventions. With the present study, we summarized the educational initiatives conducted worldwide aimed at increasing citizens' literacy in omics sciences.

Materials and Methods

We conducted a web search of the educational initiatives aimed at improving citizens' literacy in omics sciences undertaken worldwide, by using three search engines (Google, Bing, and Yahoo Search), in English and in Italian languages.

Results

We identified five initiatives in Europe, 22 in non-European countries, and 13 in Italy. Overall, the majority (69%) were web-based initiatives, while 31% required in-person attendance. The online initiatives included web pages for reading, online lessons/courses, web portals, videos/short movies, animations, and apps for mobile devices. The residential initiatives, on the other hand, included exhibitions, seminars, courses, symposia, information stands in public places, guided visits to research laboratories, and interactive laboratories. All the initiatives were highly heterogeneous in terms of methodologies and the topics addressed.

Discussion and Conclusion

Overall, we identified a variety of initiatives aimed at improving citizens' literacy in omics sciences, with the largest majority carried out in the United States and being web-based. Our results showed heterogeneity among the initiatives as to the dealt topics and the adopted methods. Further research is needed, however, to quantitatively assess the effectiveness of educational initiatives to improve citizens' literacy in omics sciences.

[The normative legal regulation of medical care support of rare (orphan) diseases in adult population of The Russian Federation]

The article considers the results of legal regulation analysis of medical care support including medication maintenance of adult patients suffering from rare diseases exemplified by life-threatened and chronic progressed rare (orphan) diseases resulting in life expectancy decrease and or disability ("List-24").

MATERIALS AND METHODS

Law database was analyzed in terms of current orders of medical care provision, standards of medical care, and clinical guidelines for rare diseases from "List-24" regarding to adult patients.

RESULTS

It is concluded that there are no determined rules of medical care provision to adult population in case of rare diseases from "List-24". There are standards of medical care on 6 rare diseases (25% of total diseases amount) from this list for adult patients. However, based on content analysis data of approved standards it was established that there are only 3 from 11 standards (27.28%) for primary medical care support, 4 standards (33.34%) for medical care provision in planned condition, and only 1 standard (9.09%) had appropriate legal basis for its development (clinical guidelines availability). Nevertheless, there is negative prognosis for this the only standard due to legal necessity of all clinical guidelines revision till the end of 2021.

CONCLUSION

Revision and creation of clinical guidelines and standards of medical care afterwards are needed for adult patients treatment with rare diseases from "List-24". The conclusion was made in terms of medical care standardization improvement for adult patients suffering from rare diseases from "List-24" based on its alignment with current legal regulation.

Policy for science by ballot or by roll call? Observations from stem cell research policymaking

This study compares stem cell research policymaking by legislators and citizens in the United States. First, using exit poll results from a 2006 stem cell research initiative in Missouri, the study finds that deeply held personal values such as religious beliefs and views of abortion predominate in an individual's voting decision on this issue; second, an analysis of voting behavior by senators on the Stem Cell Research Enhancement Act of 2005 finds that senators make their voting decisions based on their personal policy preferences rather than their constituents' preferences; and third, the complexity of the Missouri citizen initiative is compared with that of the legislation in the U.S. Senate, finding that the language of the citizen initiative is more sophisticated than the language of the legislative act. These findings provide the context for a broader discussion of the role of citizens and legislators in making policy for science.

[18th Scientific conference Rijeka and its citizens in Medical History, November 9, 2018]

Scientific conference Rijeka and its citizens in Medical History as an 18th conference was met on November 9, 2018. Organized by the Croatian Scientific Society for the History of Health Culture, University of Rijeka, Faculty of Medicine and the State Archives in Rijeka. The eighteenth conference was held at the exhibition hall of the last, but not least organizer. The initiator of the gathering and the president of the Society prof. Ante Škrobonja with several introductory words about the long tradition of the gathering, as well as the Society, met the present with their total work and present the conference with 20 presentations held by authors from Croatia and neighbouring countries like Slovenia and Serbia. Nine presentations with specific themes about medical history in Rijeka, and 11 presentations wider spectre.

Development of a Healthy Lifestyle Assessment Toolkit for the General Public

The prevalence of age-related non-communicable chronic diseases has increased worldwide, being the leading causes of morbidity and death in many world regions, including in Europe. Innovative models and strategies focused on preventive care, including early identification of risk factors underlying disease onset and progression, and proper modification of lifestyle habits and behaviors, might contribute to promote quality of life, healthy living and active aging. Healthy Lifestyle Innovative Quarters for Cities and Citizens (HeaLIQs4cities) is an EIT Health-funded project aiming to engage, empower and educate citizens toward healthy lifestyles. One of the major objectives of this project was to develop a toolkit for a rapid and informal assessment of healthy lifestyles, to be used at different levels of care pathways, including in informal public environments. In this paper, we describe the methodology underlying the development of the toolkit, which resulted from the collaboration of an interdisciplinary focus group of academic experts, from medicine, sport sciences, psychology, health economics, and innovative technologies applied to health. The following eight components were included in the toolkit: (1) anthropometric assessment and cardiometabolic parameters; (2) physical activity and exercise; (3) well-being, social cohesion, and functional independence; (4) nutrition; (5) mental health; (6) smoking, drinking, and use of illicit substances; (7) sleep habits and quality; and (8) health and disease. A traffic light rating system indicating the risk score was used (low: green; moderate: yellow; and relevant: orange) for each of the 8 components, together with recommendations for the toolkit users. After completing the reduced version of the toolkit, individuals showing moderate or relevant risk in one or more of the 8 dimensions, were invited to participate in a more detailed assessment (toolkit long version), based on deeper and scientifically validated tools. The toolkit was incorporated in eVida, a web-based platform that focuses on delivering services to personalized health and well-being. The validation of the current toolkit has been applied in wide-ranging public events in three different European Regions. Large scale deployment of the toolkit is expected to profit from the Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA).

Should Animal Welfare Regulations Be More Restrictive? A Case Study in Eight European Union Countries

Simple Summary

Intensive animal production systems are compromising current animal welfare standards. European societies’ growing concerns regarding how animals are raised have resulted in continuous European Union (EU) policy reforms that have banned certain intensive farming methods. We investigated whether EU respondents, differentiated by their roles as citizens and consumers, believe that the current regulations on animal welfare should be more restrictive. Data were collected using a survey approach implemented in eight European countries (Spain, the United Kingdom, Poland, Greece, Lithuania, Romania, Italy, and Sweden) with a sample of 3860 respondents. The results show that women citizens are more concerned with animal welfare and are prone to accept more restrictive regulations. Respondents from northern European countries (Poland and Sweden) are willing to accept regulations that are more restrictive than the current minimum standards than respondents from southern countries (Spain and Italy). Our results suggest that increasing knowledge of animal welfare is related to effective information campaigns that use the Internet to endorse the current animal welfare legislation.

Abstract

Increasingly, intensive livestock production systems have increased societal concern regarding the current animal welfare standards. We investigated whether individuals in their roles as consumers and citizens believe that the current European regulations regarding animal welfare should be more restrictive. Factors affecting this decision were assessed by analyzing respondents’ understanding of animal welfare-related issues, their subjective and objective knowledge levels, the credibility they assign to different information sources, their perceptions toward the current restrictiveness of animal welfare standards, and their socioeconomic characteristics. Data were collected using a semi-structured questionnaire distributed in eight European Union (EU) countries (Spain, the United Kingdom, Poland, Greece, Lithuania, Romania, Italy, and Sweden) with 3860 total responses. The results showed that consumers are more reluctant to adopt more restrictive regulations than respondents in the role of citizens. Respondents from northern European countries (Poland and Sweden) are more likely to support regulations that are more restrictive than the current minimum requirements than respondents from southern countries (Spain and Italy). Women were found to be more concerned with the welfare of pigs and laying hens—lending credibility to the Internet as an information source—and were more likely to support more restrictive animal welfare legislation.

Predictors of Death Penalty Views in China: An Empirical Comparison Between College Students and Citizens

China's current Criminal Law has 46 death-eligible offenses, and China executes more people than any other country in the world. However, there is a lack of study of attitudes toward capital punishment for specific offenses, and no death penalty view comparison between college students and regular citizens in China was found. This study was taken to address these limitations. Using a sample of 401 respondents from Zhejiang, China, in 2016, the present study found that more than 72% of respondents favored the death penalty without any specification of crime types. Level of death penalty support differed by various specific crimes. As expected, relative to college students, general population citizens were more likely to support capital punishment. Both groups had the highest death penalty support for murder. The study also revealed similar and different reasons behind death penalty attitudes between college students and regular citizens.

Prioritisation of citizen-centric information for disaster response

In the aftermath of a disaster event, and in the absence of trained professionals, many responsibilities are assumed by uninjured citizens who are willing and able to help, such as care of the injured or search and rescue. These citizens are constrained by communications and logistics problems but are less equipped to deal with them as most often they are cut off from any coordinated assistance. The method proposed in this study would increase the survivability of those injured or trapped by a disaster event by providing a facility to allow citizens to coordinate and share information among themselves. This is facilitated by the proposed deployment and the autonomous management of an ad hoc infrastructure that liaises directly with survivors without central control. Furthermore, as energy concerns present critical constraints to these networks, this research proposes a system of categorising information elements within the network to ensure efficient information exchange.

Networking expertise: discursive coalitions and collaborative networks of experts in a public creationism controversy in the UK

Experts do play a particular role in public socio-scientific debates, even more so if they form heterogeneous coalition with other actors and experts. A case study about a public science education controversy surrounding the teaching of evolution/creationism in the UK press is used to investigate in detail how connections and coalitions between experts and other actors involved in the controversy emerged and played out. The research focuses on the question of what role collaborative and other networks of experts played in terms of influence, visibility, credibility, consensus and weight of argument. Issues that are considered in the research are the status of the members of the coalitions forming during the debate and how it is displayed in media representations and letters and petitions, and also how these networks and coalitions of experts perform in relation to each other.

Opinions of Swedish citizens, health-care politicians, administrators and doctors on rationing and health-care financing

OBJECTIVE

To compare the views of citizens and health-care decision-makers on health-care financing, the limits of public health-care, and resource allocation.

DESIGN

A postal survey based on a randomized sample of adults taken by the national registration and stratified samples of health-care politicians, administrators, and doctors in five Swedish counties.

PARTICIPANTS

A total number of 1194 citizens (response rate 60%) and 427 decision-makers (response rate 69%).

RESULTS

The general public have high expectations of public health-care, expectations that do not fit with the decision-makers' views on what should be offered. To overcome the discrepancy between demand and resources, physicians prefer increased patient fees and complementary private insurance schemes to a higher degree than do the other respondents. Physicians take a more favourable view of letting politicians on a national level exert a greater influence on resource allocation within public health-care. A majority of physicians want politicians to assume a greater responsibility for the exclusion of certain therapies or diagnoses. Most politicians, on the other hand, prefer physicians to make more rigorous decisions as to which medical indications should entitle a person to public health-care.

CONCLUSIONS

The gap between public expectations and health-care resources makes it more important to be clear about who should be accountable for resource-allocation decisions in public health-care. Significant differences between physicians' and politicians' opinions on financing and responsibility for prioritization make the question of accountability even more important.

Who wants to know if their care is rationed? Views of citizens and service informants

OBJECTIVE

To explore the views of citizens and service informants about whether they would want to know about any rationing of their own health care.

DESIGN

In-depth interviews using a semistructured schedule. Data were analysed using the methods of constant comparison.

SETTING AND PARTICIPANTS

Citizens and service informants.

MAIN VARIABLES STUDIED

Issues around health care rationing were explored within the context of the United Kingdom health care system.

RESULTS

The views of citizens and service informants were very similar in terms of whether they, personally, wanted to know about any rationing of their own care, with the vast majority wanting to be given this information. Informants were also similar in terms of their reasons for wanting to know about rationing: to be given a 'good explanation' to enable them to judge whether the decision made had been correct; and to enable them to change the decision if necessary, either through protest or payment. Many informants suggested that they would indeed be likely to react either by challenging the decision or by paying for care.

CONCLUSIONS

The findings suggest that policies to be open with people about the rationing of care would be welcomed, but also indicate that if protest follows such openness, it may be difficult for the health service to cope with greater explicitness. Further research is needed among patient groups actually facing this situation.