Eliciting Public Preference for Health-Care Resource Allocation in South Korea

Objectives: To identify the principles the public considers important and the trade-offs between different values in health-care resource allocation practices. Methods: This study approached the issue in both qualitative and quantitative ways. In a qualitative study, two focus groups discussed the issues of resource allocation in health care. To facilitate the discussion, a simple ranking task and a series of pairwise choice practices were implemented. A discrete choice experiment survey questionnaire was also administered to a sample of the general population. Attributes and levels were determined through literature reviews and the results from the focus group interview. We used a random-effect probit model to assess the effects of each attribute. Results: Through the focus group interviews, we found strong public support for the principle of equal opportunity. The participants thought that the severity of disease was the most important criterion when setting priorities. The majority supported the idea that the most disadvantaged should have the highest priority even when their health gains are less than those of others. The discrete choice experiment results showed that the severity of disease, health gains, and patients' socioeconomic status significantly influence their choices, with each parameter having an expected sign. Conclusion: The results showed that Koreans support not only health maximization but also equal opportunity, fair resource allocation, and equality.