SynthesisSystematic reviews2025
Public preferences for allocating health system resources in Canada: a systematic review.
Synthesis in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConventional economic evaluations are based on the principle of health maximization. However, this approach does not consider societal preferences to prioritize health care for certain social groups and health conditions, and the public concern over health disparities. In recent years, equity-informative economic evaluation methods have been developed to incorporate societal concerns over for health inequities. These methods use quantitative evidence based on preference elicitation exercises to inform allocation of health system resources.
objectiveTo systematically review Canadian studies that quantify public preferences for allocating health care resource across social groups and health conditions.
methodsThree electronic databases were searched on January 1st, 2024: Ovid Embase, Ovid MEDLINE, and EBSCO EconLit. In addition, the reference lists of relevant papers were also scanned to detect any other suitable studies. The systematic review included studies that met the following criteria: they were survey-based, sampled Canadian residents and involved preference elicitation, where participants made decisions about resource allocation or responded to hypothetical scenarios about redistributing lifetime health. Qualitative studies and non-preference-based studies were excluded. Risk of Bias was assessed using the CLARITY Group's tool for evaluating cross-sectional surveys of attitudes and practices. Two reviewers conducted screening, full-text review, and data extraction. Studies were narratively synthesized.
resultsEight studies, with 8,969 participants, were identified that investigated public preferences for prioritizing health care in relation to age, income, disease rarity, and baseline health. Age-related preferences tended to favor children and younger patients over older patients. Aversion to socioeconomic-related health inequality was heterogeneous and was associated with respondent characteristics. No clear preference was found for treatments for rare diseases over common conditions, or for baseline quality of life and life expectancy. Two studies exposed participants to moral reasoning exercises that led to slightly lower levels of preference for prioritization of specific conditions or groups.
conclusionWhile the identified studies in the review were heterogenous, they provide some evidence supporting the prioritization of healthcare resources for children and younger patients over older patients. There is limited Canadian evidence on societal values related to health inequity associated with socioeconomic status, sex/gender, race/ethnicity, and other social determinants of health. Future research can help bridge this gap.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.