Public Preferences for Allocating Ventilators in an Intensive Care Unit: A Discrete Choice Experiment

Norman, R; Robinson, S; Dickinson, H; Williams, I; Meshcheriakova, E; Manipis, K; Anstey, M

Public Preferences for Allocating Ventilators in an Intensive Care Unit: A Discrete Choice Experiment

Norman, R Robinson, S Dickinson, H Williams, I Meshcheriakova, E Manipis, K

Anstey, M

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Publisher:: Adis
Publication Type:: Journal Article
Citation:: The Patient: Patient Centered Outcomes Research, 2021, 14, (3), pp. 319-330
Issue Date:: 2021-03-04

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Field	Value	Language
dc.contributor.author	Norman, R
dc.contributor.author	Robinson, S
dc.contributor.author	Dickinson, H
dc.contributor.author	Williams, I
dc.contributor.author	Meshcheriakova, E
dc.contributor.author	Manipis, K https://orcid.org/0000-0002-7159-0912
dc.contributor.author	Anstey, M
dc.date.accessioned	2021-12-22T04:59:57Z
dc.date.available	2021-02-05
dc.date.available	2021-12-22T04:59:57Z
dc.date.issued	2021-03-04
dc.identifier.citation	The Patient: Patient Centered Outcomes Research, 2021, 14, (3), pp. 319-330
dc.identifier.issn	1178-1653
dc.identifier.issn	1178-1661
dc.identifier.uri	http://hdl.handle.net/10453/152470
dc.description.abstract	Background and Objective During the COVID-19 pandemic, resources in intensive care units (ICUs) have the potential to be inadequate to treat all those who might benefit. Therefore, it is paramount to identify the views of the community regarding how to allocate such resources. This study aims to quantify Australian community preferences for ventilation allocation. Methods A discrete choice experiment was designed and administrated to an adult Australian online panel. Each survey respondent answered 12 choice sets from a total design of 120. Each choice set placed the respondent in the role of hypothetical decision maker, prioritising care between two patients. Conditional logit, mixed logit regression and latent class analysis were used to analyse the data. Additionally, we asked a series of attitudinal questions about different methods of making such decisions in practice, focusing on who should be responsible. Results A total of 1050 community members completed the survey and responded to each choice. Dimensions considered most important were age, likely effectiveness, smoking status, whether the person has dependents, whether they are a healthcare worker, and whether they have a disability or not. Estimating marginal rates of substitution between patient characteristics and chance of survival if ventilated yielded values of up to 30 percentage points if the patient was 70 years old relative to being 30. However, respondents typically said they would prefer such decisions to be made by medical professionals. Conclusion This study demonstrated the preferences of the community to allocation of ventilators during the COVID-19 pandemic. The use of such information should be treated with some caution as the underlying reason for such preferences are unclear, and respondents themselves preferred the decision to be made by others.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Adis
dc.relation.ispartof	The Patient: Patient Centered Outcomes Research
dc.relation.isbasedon	10.1007/s40271-021-00498-z
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.mesh	Humans
dc.subject.mesh	Ventilators, Mechanical
dc.subject.mesh	Smoking
dc.subject.mesh	Choice Behavior
dc.subject.mesh	Age Factors
dc.subject.mesh	Quality-Adjusted Life Years
dc.subject.mesh	Health Care Rationing
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.subject.mesh	Pandemics
dc.subject.mesh	COVID-19
dc.subject.mesh	SARS-CoV-2
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Age Factors
dc.subject.mesh	Aged
dc.subject.mesh	Australia
dc.subject.mesh	COVID-19
dc.subject.mesh	Choice Behavior
dc.subject.mesh	Female
dc.subject.mesh	Health Care Rationing
dc.subject.mesh	Humans
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pandemics
dc.subject.mesh	Quality-Adjusted Life Years
dc.subject.mesh	SARS-CoV-2
dc.subject.mesh	Smoking
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Ventilators, Mechanical
dc.subject.mesh	Young Adult
dc.title	Public Preferences for Allocating Ventilators in an Intensive Care Unit: A Discrete Choice Experiment
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	New Zealand
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-12-22T04:59:48Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	14
utslib.citation.issue	3

Abstract:

Background and Objective During the COVID-19 pandemic, resources in intensive care units (ICUs) have the potential to be inadequate to treat all those who might benefit. Therefore, it is paramount to identify the views of the community regarding how to allocate such resources. This study aims to quantify Australian community preferences for ventilation allocation. Methods A discrete choice experiment was designed and administrated to an adult Australian online panel. Each survey respondent answered 12 choice sets from a total design of 120. Each choice set placed the respondent in the role of hypothetical decision maker, prioritising care between two patients. Conditional logit, mixed logit regression and latent class analysis were used to analyse the data. Additionally, we asked a series of attitudinal questions about different methods of making such decisions in practice, focusing on who should be responsible. Results A total of 1050 community members completed the survey and responded to each choice. Dimensions considered most important were age, likely effectiveness, smoking status, whether the person has dependents, whether they are a healthcare worker, and whether they have a disability or not. Estimating marginal rates of substitution between patient characteristics and chance of survival if ventilated yielded values of up to 30 percentage points if the patient was 70 years old relative to being 30. However, respondents typically said they would prefer such decisions to be made by medical professionals. Conclusion This study demonstrated the preferences of the community to allocation of ventilators during the COVID-19 pandemic. The use of such information should be treated with some caution as the underlying reason for such preferences are unclear, and respondents themselves preferred the decision to be made by others.

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

http://hdl.handle.net/10453/152470