Health-Related Quality of Life as a Criterion for Priority Setting in Peripheral Arterial Disease
Eine interviewbasierte qualitative Analyse der Präferenzen verschiedener StakeholdergruppenPDF german translation / full article
An Interview-Based Qualitative Stakeholder Analysis
Background: Priority setting in medicine means the explicit definition of prioritized indications, patient groups or methods above others, especially under circumstances of relative scarcity of resources. Here, we analyse the perspectives of various stakeholder groups regarding health-related quality of life as a potential criterion for priority setting.
Methods: We performed a qualitative preference analysis by semi-structured interviews of 6 stakeholder groups (7 physicians, 8 patients with peripheral arterial disease, 9 relatives of patients, 3 nurses, 3 members of the medical service of the statutory health insurance and 9 „uninvolved“ others representing the general public). The 2nd stage of peripheral arterial disease was selected as prioritizing context. The interviews were recorded, transcribed and the content analyzed according to Mayring using the software f4.
Results: Health-related quality of life was regarded as a relevant criterion for priority setting. Patterns of argumentation and explanation for both pro and con its implementation were introduced in the interviews. On one hand, health-related quality of life was mentioned as an important way of taking the patient perspective into account, on the other hand, its objectivity was questioned.
Conclusions: The analysis of the interviews conveyed that health-related quality of life may be used as both a criterion of fairness and of efficiency for priority setting in medicine. Priority setting is a complex process for which no easy solutions exist for implementation. It will be crucial to continue the started discussion to increase both the awareness of the problem and the acceptance within the public.