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Cardenas HC, Carson RT, Hanemann M, et al. Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19. Emerg Med J. 2022;doi: 10.1136/emermed-2021-211297.
Cardenas, H. C., Carson, R. T., Hanemann, M., Louviere, J. J., & Whittington, D. (2022). Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19. Emergency medicine journal : EMJ, . https://doi.org/10.1136/emermed-2021-211297
Cardenas, Helena C, et al. "Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19." Emergency medicine journal : EMJ vol. (2022). doi: https://doi.org/10.1136/emermed-2021-211297
Cardenas HC, Carson RT, Hanemann M, Louviere JJ, Whittington D. Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19. Emerg Med J. 2022 Jan 03; doi: 10.1136/emermed-2021-211297. Epub 2022 Jan 03. PMID: 34980678; PMCID: PMC8753109.
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Emerg Med J. 2022 Jan 03; doi: 10.1136/emermed-2021-211297. Epub 2022 Jan 03.

Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19.

Emergency medicine journal : EMJ

Helena C Cardenas, Richard T Carson, Michael Hanemann, Jordan J Louviere, Dale Whittington

Affiliations

  1. City and Regional Planning, University of North Carolina at Chapel Hill College of Arts and Sciences, Chapel Hill, North Carolina, USA.
  2. Economics, University of California at San Diego, San Diego, California, USA.
  3. Economics, Arizona State University, Tempe, Arizona, USA.
  4. Marketing, University of South Australia Business School, Adelaide, South Australia, Australia.
  5. City and Regional Planning, University of North Carolina at Chapel Hill College of Arts and Sciences, Chapel Hill, North Carolina, USA [email protected].
  6. Environmental Sciences and Engineering, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.

PMID: 34980678 PMCID: PMC8753109 DOI: 10.1136/emermed-2021-211297

Abstract

OBJECTIVE: To determine the relative importance members of the US public place on different patient attributes in triage decisions about who should receive the last available intensive care unit (ICU) bed.

METHODS: A discrete choice experiment was conducted with a nationally representative sample of 2000 respondents from the YouGov internet panel of US households. Respondents chose which of three hypothetical patients with COVID-19 should receive an ICU bed if only one were available. The three patients differed in age, gender, Alzheimer's-like disability and probability of survival if the patient received the ICU bed. An experimental design varied the values of the four attributes of the three hypothetical patients with COVID-19 that a respondent saw in four choice tasks.

RESULTS: The most important patient attribute to respondents was the probability the patient survives COVID-19 if they get the ICU bed (OR CI: 4.41 to 6.91). There was heterogeneity among different age groups of respondents about how much age of the patient mattered. Respondents under 30 years of age were more likely to choose young patients and old patients, and less likely to select patients aged 40-60 years old. For respondents in the age group 30-49 years old, as the age of the patient declined, their preference for saving the patient declined modestly in a linear fashion.

CONCLUSIONS: Respondents favoured giving the last ICU bed available to the patient with the highest probability of surviving COVID-19. Public opinion suggests a simple guideline for physician choices based on likelihood of survival as opposed to the number of life-years saved. There was heterogeneity among respondents of different age groups for allocating the last ICU bed, as well as to the importance of the patient having an Alzheimer's-like disability (where religion of the respondent is important) and the gender of the patient (where the gender and racial identity are important).

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: COVID-19; triage

Conflict of interest statement

Competing interests: None declared.

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