Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, 1417613151, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, 1417613151, Iran.
BMC Public Health. 2022 Nov 8;22(1):2038. doi: 10.1186/s12889-022-14404-1.
Priority setting in health directly impacts the general public as payers and final consumers, so the public preferences must be considered. The present study aimed to provide public preferences about health intervention allocation criteria for the optimal allocation of public health budget in Iran.
A choice-based survey method was used to assess the general public's preferences regarding 8 critical criteria with a societal aspect. One thousand sixty-four adult citizens of Tehran, Iran, participated in the study. Participants were asked to allocate a hypothetical budget between the two groups with differences in allocation criteria. Public preferences were inferred from absolute majority responses i.e., more than 50% of participants' allocation for a criterion. The Logistic Regression Model was used to investigate the factors affecting the preferences regarding the importance of allocation criteria.
Based on expressed participants' preferences, criteria of disease severity, age, daily care needs, Number of alternative interventions, individual's economic status, and diseases with absence from work were important. Thus, 77, 69, 61, 57, 54, and 51% of participants preferred to allocate the hypothetical budget to the treatment of patients with poor economic status, treatment of patients with diseases leading to absence from work, treating patients with severe diseases, treatment of diseases in need of daily care and treatment of children's diseases, respectively. Findings from the factors affecting participants' preferences regarding allocation criteria also showed that people with different characteristics had different preferences.
Iranian general public pays special attention to the criteria of equitable allocation, including patients' economic status, criteria with societal aspects such as absenteeism from work and the need for daily care, as well as criteria with medical aspects such as disease severity and access to alternative interventions which may sometimes be less considered in decision making.
卫生保健的优先事项直接影响到作为支付者和最终消费者的广大公众，因此必须考虑公众的偏好。本研究旨在为伊朗公共卫生预算的最优分配提供公众对卫生干预分配标准的偏好。
采用基于选择的调查方法评估 8 个具有社会方面的关键标准，这些标准是公众的偏好。1064 名伊朗德黑兰的成年公民参与了这项研究。要求参与者在分配标准存在差异的两组之间分配一个假设的预算。根据绝对多数的回答推断出公众的偏好，即超过 50%的参与者对某个标准的分配。使用逻辑回归模型来研究影响分配标准重要性偏好的因素。
根据表达的参与者偏好，疾病严重程度、年龄、日常护理需求、替代干预措施的数量、个人经济状况和缺勤疾病等标准是重要的。因此，77%、69%、61%、57%、54%和 51%的参与者分别倾向于将假设预算分配给治疗经济状况较差的患者、治疗导致缺勤的疾病患者、治疗严重疾病患者、治疗需要日常护理的疾病和治疗儿童疾病。影响参与者对分配标准偏好的因素的研究结果还表明，具有不同特征的人有不同的偏好。
伊朗公众特别关注公平分配标准，包括患者的经济状况、与社会方面相关的标准，如缺勤和日常护理需求，以及与医疗方面相关的标准，如疾病严重程度和获得替代干预措施，这些标准在决策制定中有时可能较少考虑。
