title: Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.
abstract: OBJECTIVE
  To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints.
  
  
  METHODS
  Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis.
  
  
  RESULTS
  Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model.
  
  
  CONCLUSIONS
  The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.
authors: Department of Health Sciences, Division of Nursing, Lund University, Sweden. elisabet.werntoft@med.lu.se
authors: Elisabet
authors: E
authors: Werntoft
authors: Anna-Karin
authors: AK
authors: Edberg
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010822:Physicians, Women / Q000523:psychology; D017410:Practice Guidelines as Topic; D040841:Resource Allocation; D011795:Surveys and Questionnaires; D013548:Sweden