Preferences for Allocating Health Care Resources by Age: Results from a Nationally Representative Survey of US Adults
Christopher J. Cadham, Lisa A. ProsserObjective:
To examine preferences for allocating scarce health resources between age groups: 10, 40, and 75 y old.
Methods:
We fielded a set of Bognar-style allocation questions to a nationally representative sample of 1,122 US adults through the NORC AmeriSpeak Survey. Respondents allocated 1) life-extending or 2) life-saving treatments in 2 choice tasks: A) select a single age group to treat and B) allocate 100 treatments across the age groups. We calculated the proportion of respondents who selected each age group and the mean number of treatments allocated to each age group.
Results:
For task 1A, 60.4% of respondents selected age 10, 30.5% selected age 40, and 5.9% selected age 75, compared with 76.6%, 17.9%, and 1.8% for task 1B. For task 2A, an average of 51.5 treatments were allocated to age 10, 33.3 to age 40, and 15.2 to age 75, compared with 62.2, 27.9, and 9.8 for task 2B. In task 2B, 37.8% of treatments were allocated to older ages.
Conclusions:
Most respondents preferred treating children in both frames, but a minority of respondents maximized life-years gained. Results from this representative sample underscore the importance of considering age and the context-dependent nature of resource allocation decisions.