[Allocation of resources in patients with bad prognosis: the need for debate].
OBJECTIVE
Assess the opinion of health care professions on the awarding of resources when the patient has a bad prognosis.


METHODS
Survey type test where a scenario of a patient with a 6 month life prognosis is posed, differentiating between good and bad quality of life. It is evaluated if the following resources would be indicated if necessary: admission to ICU, hemodialysis, hip prosthesis, transplant, Hospital admission, antibiotics for bacterial infection, permanent pacemaker and surgery. To analyze the possible association between the variables, the Pearson's Chi Square Test or that of linear tendency was used. To determine if each person interviewed was appropriate in a different way based on the patient's quality of life status, the McNemar test was used.


METHODS
University Hospital of 480 beds.


METHODS
Sample of 256 volunteers (physicians and nurses) from the Emergency Service, Intensive Care Unit and Operating Room.


METHODS
A responsible physician was in charge of personally distributing the survey during a 2-week period and to explain the possible doubts that could arise on it.


RESULTS
A total of 23.8% of those surveyed considered that transplant would be indicated and 79.8% that permanent pacemaker would be indicated if the patient had a good quality of life. If there was bad quality of life, 9.1% would have always indicated hemodialysis (60.5% never), 2.8% hip prosthesis (81.1% never) and 4% complex surgery (78.8% never). There were also significant differences in all the variables studied, depending on whether the patient had good or bad quality of life.


CONCLUSIONS
There is great variability on the allotment of resources for patients with limited possibilities of survival.
Solsona
J F
JF
Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, España. 13713@imas.imim.es
Díaz
Y
Y
Iglesias
M L
ML
Gracia
M P
MP
Pérez
A
A
Vázquez
A
A
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology; D001291:Attitude of Health Personnel; D001424:Bacterial Infections / Q000188:drug therapy / Q000523:psychology; D003625:Data Collection; D034462:Dissent and Disputes; D004636:Emergency Service, Hospital; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008017:Life Expectancy; D008297:Male; D018447:Medical Futility / Q000523:psychology; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D016377:Organ Transplantation / Q000523:psychology; D010138:Pacemaker, Artificial / Q000523:psychology; D010820:Physicians / Q000523:psychology*; D011379:Prognosis; D011788:Quality of Life; D040841:Resource Allocation / Q000592:standards; D013503:Surgery Department, Hospital; D013514:Surgical Procedures, Operative / Q000523:psychology
D000900:Anti-Bacterial Agents