This article aims to investigate to what extent health care professionals in Portugal find health-related behaviors relevant as a criterion to priority setting, to study what type of risk behavior they consider relevant in such decisions and to compare their views with those of laypersons. An online questionnaire was used to collect data from a sample of 178 health care professionals and 295 laypersons. The statistical analysis was performed through the application of generalized linear models and logistic regressions. Health professionals consider more than laypersons that information about health-related behaviors is relevant in prioritization between individuals. Both groups regard information about illegal drug abuse, excessive alcohol consumption, and smoking more important to priority setting decisions than information about overweight or lack of physical exercise. The findings are important for the definition of rationing policies as the professionals’ decisions are those that, ultimately, influence health expenditure.
AlpinarZ.CivanerM.ÖrsY. (2010). Rationing healthcare: Should life-style be used as a criterion?Anatolian Journal of Cardiology, 10, 367-371.
2.
BartleyM. (2004). Health inequality: An introduction to theories, concepts and methods. Cambridge, England: Polity Press.
3.
BorgesA.PinhoM. (2017). Should lifestyles be a criterion for healthcare rationing? Evidence from a Portuguese survey. Journal of Research in Health Sciences, 17(4), 1-7.
4.
BotelhoA.PinhoM.VeigaP. (2014). Who should participate in health care priority setting and how should priorities be set? Evidence from a Portuguese survey. Revista Portuguesa Saúde Pública, 31, 214-222.
5.
BringedalB.FeiringE. (2011). On the relevance of personal responsibility in priority setting: A cross-sectional survey among Norwegian medical doctors. Journal of Medical Ethics, 37, 357-361.
6.
BuyxA. (2008). Personal responsibility for health as a rationing criterion: Why we don’t like it and why maybe we should. Journal of Medical Ethics, 34, 871-874.
7.
CallahanD.KoenigB.MinklerM. (1999). Promoting health and preventing diseases: Ethical demands and social challenges. International Quarterly of Community Health Education, 18, 163-180.
8.
CappelenA.NorheimO. (2005). Responsibility in health care: a liberal egalitarian approach. Journal of Medical Ethics, 31, 476-480.
9.
CoveyJ.RobinsonA.Jones-LeeM.LoomesG. (2010). Responsibility, scale and valuation of rail safety. Journal Risk Uncertain, 40, 85-108.
10.
DanielsN.SabinJ. (1997). Limits to health care: Fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy and Public Affairs, 26, 303-350.
Diário da República n. (2014). Lei consolidando a legislação em matéria Direitos e deveres do utente dos serviços de saúde. [Law consolidating the legislation on the rights and duties of the user of health services]. Retrieved from https://dre.pt/web/guest/pesquisa/-/search/571943/details/maximized
EloI. (2009). Social class differentials in health and mortality: Pattern and explanations in comparative perspectives. Annual Review Sociology, 35, 553-572.
ExelJ.BakerR.MasonH.DonaldsonC.BrouweW. (2015). Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology. Social Science & Medicine, 126, 128-137.
17.
FortesP.ZoboliE. (2002). A study on the ethics of microallocation of scarce resources in health care. Journal of Medical Ethics, 28, 266-269.
18.
FriscoeM.HouleJ.MartinA. (2010). The image in the mirror and the number on the scale: Weight, weight preferences, and adolescent depressive symptoms. Journal of Health and Social Behavior, 51, 215-228.
19.
GuY.LancsarE.GhijbenP.ButlerJ.DonaldsonC. (2015). Attributes and weights in healthcare priority setting: A systematic review of what counts and to what extent. Social Science & Medicine, 146, 41-52.
20.
JepsonR.HarrisF.PlattS.TannahillC. (2010). The effectiveness of interventions to change six health behaviors: A review of reviews. BMC Public Health, 10, 538. doi:10.1186/1471-2458-10-538
21.
LopesC.TorresD.OliveiraA.SeveroM.AlarcãoV.GuiomarS.. . . Consórcio, IAN-AF. (2017). Inquérito Alimentar Nacional e de Atividade Física 2015-2016: Relatório metodológico [National food and physical activity survey 2015-2016: Methodological report]. Retrieved from https://ian-af.up.pt/sites/default/files/IAN-AF%20Relatorio%20Metodol%C3%B3gico.pdf
22.
MarmotM.WilkinsonR. (2006). Social determinants of health. Oxford, England: Oxford University Press.
23.
MinklerM. (1999). Personal responsibility for health? A review of the arguments and the evidence of century’s end. Health Education Behavior, 26, 121-140.
24.
MiraldoM.GalizziM.MerlaA.LevaqqiR.SchulzP.AuxiliaF.. . . GellatiU. (2014). Should I pay for your risky behaviours? Evidence from London. Preventive Medicine, 66, 145-158.
25.
MulhernB.LongworthL.BrazierJ.RowenD.BansbackN.DevlinN.TsuchiyaA. (2013). Binary choice health state valuation and mode of administration: Head-to-head comparison of online and CAPI. Value in Health, 16, 104-113.
26.
NelderJ.WedderburnR. (1972). Generalized linear models. Journal of the Royal Statistical Society: Series A (General), 135, 370-384.
OlsenJ.RichardsonJ.DolanP.MenzelP. (2003). The moral relevance of personal characteristics in setting health care priorities. Social Science & Medicine, 73, 1163-1172.
29.
∅vrumA.RickertsenK. (2015). Inequality in health versus inequality in lifestyles. Nordic Journal of Health, 1, 18-33.
30.
PinhoM.BorgesA.ZaharievB. (2017). Bedsides healthcare rationing dilemmas: A survey from Bulgaria and comparison with Portugal. Social Theory & Health, 15, 285-301.
31.
Pordata. (2018). Portugal, População [Portugal population]. Fundação Francisco Manuel dos Santos. Retrieved from https://www.pordata.pt/Portugal
32.
RoggeJ.KittelB. (2016). Who shall not be treated: Public attitudes on setting health care priorities by person-based criteria in 28 nations. PLoS One, 11, e0157018.
33.
RowenD.BrazierJ.KeetharuthA.TsuchiyaA.MukuriaC. (2016). Comparison of modes of administration and alternative formats for eliciting societal preferences for burden of illness. Applied Health Econ Health Policy, 14(1), 89-104.
SchmidtH. (2009). Just health responsibility. Journal Medical Ethics, 35, 21-26.
36.
SchmidtH.AschD.HalpernS. (2012). Fairness and wellness incentives: What is the relevance of the process-outcome distinction?Prevention Medicine, 55(Suppl.), 5118-5123.
37.
SchmidtH.VoigtK.WiklerD. (2010). Carrots, sticks, and health care reform: Problems with wellness incentives. New England Journal of Medicine, 362, e3 doi:10.1056/NEJMp0911552
38.
SchmueliA. (2000). Horizontal equity in medical care: A case study of Israeli public’s views. Israel Medical Association Journal, 2, 746-752.
39.
SchwappachD. (2003). Does it matter who you are or what you gain? An experimental study of preferences for resource allocation. Health Economics, 12, 255-267.
StegemanI.WillemsD.DekkerE.BossuytP. (2014). Individual responsibility, solidarity and differentiation in healthcare. Public Health Ethics, 40, 770-773.
42.
TrannoyA.TubeufS.JusotF.DevauxM. (2010). Inequalities of opportunities in health in France: A first pass. Health Economics, 19, 921-938.
43.
TrappenburgM. (2000). Lifestyle solidarity in the healthcare system. Health Care Analysis, 8, 65-75.
44.
TubeufS.JusotF.BicardD. (2012). Mediating role of education and lifestyles in the relationship between early-life conditions and health: Evidence from the British cohort. Health Economics, 21(Suppl.), 129-150.
45.
VenkatapuramS.MarmotM. (2009). Epidemiology and social justice in light of social determinants of health research. Bioethics, 23(2), 79-89.
