Who Gets the Last Bed? A Discrete-Choice Experiment Examining General Population Preferences for Intensive Care Bed Prioritization in a Pandemic.

Street, AE; Street, DJ; Flynn, GM

Who Gets the Last Bed? A Discrete-Choice Experiment Examining General Population Preferences for Intensive Care Bed Prioritization in a Pandemic.

Street, AE Street, DJ Flynn, GM

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Medical decision making : an international journal of the Society for Medical Decision Making, 2021, pp. 272989X21996615
Issue Date:: 2021-03-04

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Field	Value	Language
dc.contributor.author	Street, AE
dc.contributor.author	Street, DJ
dc.contributor.author	Flynn, GM
dc.date.accessioned	2021-03-26T04:47:39Z
dc.date.available	2021-03-26T04:47:39Z
dc.date.issued	2021-03-04
dc.identifier.citation	Medical decision making : an international journal of the Society for Medical Decision Making, 2021, pp. 272989X21996615
dc.identifier.issn	0272-989X
dc.identifier.issn	1552-681X
dc.identifier.uri	http://hdl.handle.net/10453/147544
dc.description.abstract	<h4>Objective</h4>To explore the key patient attributes important to members of the Australian general population when prioritizing patients for the final intensive care unit (ICU) bed in a pandemic over-capacity scenario.<h4>Methods</h4>A discrete-choice experiment administered online asked respondents (<i>N</i> = 306) to imagine the COVID-19 caseload had surged and that they were lay members of a panel tasked to allocate the final ICU bed. They had to decide which patient was more deserving for each of 14 patient pairs. Patients were characterized by 5 attributes: age, occupation, caregiver status, health prior to being infected, and prognosis. Respondents were randomly allocated to one of 7 sets of 14 pairs. Multinomial, mixed logit, and latent class models were used to model the observed choice behavior.<h4>Results</h4>A latent class model with 3 classes was found to be the most informative. Two classes valued active decision making and were slightly more likely to choose patients with caregiving responsibilities over those without. One of these classes valued prognosis most strongly, with a decreasing probability of bed allocation for those 65 y and older. The other valued both prognosis and age highly, with decreasing probability of bed allocation for those 45 y and older and a slight preference in favor of frontline health care workers. The third class preferred more random decision-making strategies.<h4>Conclusions</h4>For two-thirds of those sampled, prognosis, age, and caregiving responsibilities were the important features when making allocation decisions, although the emphasis varies. The remainder appeared to choose randomly.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation.ispartof	Medical decision making : an international journal of the Society for Medical Decision Making
dc.relation.isbasedon	10.1177/0272989x21996615
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.classification	Health Policy & Services
dc.title	Who Gets the Last Bed? A Discrete-Choice Experiment Examining General Population Preferences for Intensive Care Bed Prioritization in a Pandemic.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	recently_added	*
dc.date.updated	2021-03-26T04:47:38Z
pubs.publication-status	Published

Abstract:

Objective

To explore the key patient attributes important to members of the Australian general population when prioritizing patients for the final intensive care unit (ICU) bed in a pandemic over-capacity scenario.

Methods

A discrete-choice experiment administered online asked respondents (N = 306) to imagine the COVID-19 caseload had surged and that they were lay members of a panel tasked to allocate the final ICU bed. They had to decide which patient was more deserving for each of 14 patient pairs. Patients were characterized by 5 attributes: age, occupation, caregiver status, health prior to being infected, and prognosis. Respondents were randomly allocated to one of 7 sets of 14 pairs. Multinomial, mixed logit, and latent class models were used to model the observed choice behavior.

Results

A latent class model with 3 classes was found to be the most informative. Two classes valued active decision making and were slightly more likely to choose patients with caregiving responsibilities over those without. One of these classes valued prognosis most strongly, with a decreasing probability of bed allocation for those 65 y and older. The other valued both prognosis and age highly, with decreasing probability of bed allocation for those 45 y and older and a slight preference in favor of frontline health care workers. The third class preferred more random decision-making strategies.

Conclusions

For two-thirds of those sampled, prognosis, age, and caregiving responsibilities were the important features when making allocation decisions, although the emphasis varies. The remainder appeared to choose randomly.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/147544