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公众对 COVID-19 大流行期间公平分配呼吸机的优先事项的意见:一项全国性调查。

Public Opinion on Priorities Toward Fair Allocation of Ventilators During COVID-19 Pandemic: A Nationwide Survey.

机构信息

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Front Public Health. 2021 Dec 14;9:753048. doi: 10.3389/fpubh.2021.753048. eCollection 2021.

Abstract

The rapidly growing imbalance between supply and demand for ventilators during the COVID-19 pandemic has highlighted the principles for fair allocation of scarce resources. Failing to address public views and concerns on the subject could fuel distrust. The objective of this study was to determine the priorities of the Iranian public toward the fair allocation of ventilators during the COVID-19 pandemic. This anonymous community-based national study was conducted from May 28 to Aug 20, 2020, in Iran. Data were collected via the Google Forms platform, using an online self-administrative questionnaire. The questionnaire assessed participants' assigned prioritization scores for ventilators based on medical and non-medical criteria. To quantify participants' responses on prioritizing ventilator allocation among sub-groups of patients with COVID-19 who need mechanical ventilation scores ranging from -2, very low priority, to +2, very high priority were assigned to each response. Responses of 2,043 participants, 1,189 women, and 1,012 men, were analyzed. The mean (SD) age was 31.1 (9.5), being 32.1 (9.3) among women, and 29.9 (9.6) among men. Among all participants, 274 (13.4%) were healthcare workers. The median of assigned priority score was zero (equal) for gender, age 41-80, nationality, religion, socioeconomic, high-profile governmental position, high-profile occupation, being celebrities, employment status, smoking status, drug abuse, end-stage status, and obesity. The median assigned priority score was +2 (very high priority) for pregnancy, and having <2 years old children. The median assigned priority score was +1 (high priority) for physicians and nurses of patients with COVID-19, patients with nobel research position, those aged <40 years, those with underlying disease, immunocompromise status, and malignancy. Age>80 was the only factor participants assigned -1 (low priority) to. Participants stated that socioeconomic factors, except for age>80, should not be involved in prioritizing mechanical ventilators at the time of resources scarcity. Front-line physicians and nurses of COVID-19 patients, pregnant mothers, mothers who had children under 2 years old were given high priority.

摘要

在 COVID-19 大流行期间,呼吸机的供需迅速失衡,这凸显了公平分配稀缺资源的原则。如果未能解决公众对此问题的看法和担忧,可能会加剧不信任。本研究旨在确定伊朗公众在 COVID-19 大流行期间公平分配呼吸机的优先级。

这项匿名的基于社区的全国性研究于 2020 年 5 月 28 日至 8 月 20 日在伊朗进行。数据通过 Google Forms 平台收集,采用在线自我管理问卷。该问卷根据医疗和非医疗标准评估参与者对呼吸机分配的优先排序得分。为了量化参与者对需要机械通气的 COVID-19 患者亚组之间呼吸机分配优先级的反应,为每个反应分配了从-2(非常低优先级)到+2(非常高优先级)的分数。对 2043 名参与者(1189 名女性和 1012 名男性)的回复进行了分析。平均(SD)年龄为 31.1(9.5),女性为 32.1(9.3),男性为 29.9(9.6)。在所有参与者中,有 274 名(13.4%)是医疗保健工作者。性别、41-80 岁、国籍、宗教、社会经济地位、政府要员、知名职业、名人、就业状况、吸烟状况、药物滥用、终末期状态和肥胖等因素的分配优先级评分中位数均为零(相等)。怀孕和有 2 岁以下儿童的分配优先级评分中位数为+2(非常高优先级)。COVID-19 患者的医生和护士、有诺贝尔奖研究职位的患者、年龄<40 岁的患者、有基础疾病、免疫功能低下状态和恶性肿瘤的患者的分配优先级评分中位数为+1(高优先级)。只有年龄>80 岁是参与者分配-1(低优先级)的唯一因素。

参与者表示,在资源短缺时,除了年龄>80 岁以外,不应将社会经济因素纳入机械呼吸机的优先级排序。COVID-19 患者的一线医生和护士、孕妇、有 2 岁以下孩子的母亲被给予高优先级。

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