Objective To describe the views of people, 65 years and over, receiving continuous public care and service, on prioritization and resource allocation in health care, in relation to gender, age, housing, health-related quality of life (QoL) and degree of activities of daily living (ADL) dependency.Background How older people receiving continuous public care and service view prioritization and resource allocation in health care is sparsely investigated, although this group most certainly has the experience and also often is the target in discussions concerning prioritization. It is necessary, for democracy and for the development of new models of service delivery, to find out how people receiving long-term care and service view these issues.

The number of older people has increased and so also the use of expensive treatments and medicine. Some sectors and patients have been prioritised while others have been set aside, deliberately or not. Knowing that there are different views on the subject it is important to find out how older people reason about age-related prioritisation in health care. The aim of this study was to describe the reasoning of people, 60 years and over, about prioritisation in health care with regard to age and willingness to pay. Healthy people (n=300) and people receiving continuous care and service (n=146)

Older people's views of priorities seem to differ from previous population-based studies, in that age per se as a criterion for selection between patients was not favored; health and wellbeing were more important. Differences were, however, found within the group of older people, as regards both age and gender.

2 ABSTRACT Purpose of this paperThe aim of this study was to describe the view of age-related prioritisation in health care among physicians and healthcare politicians and to compare their views regarding gender and age. MethodologySwedish physicians (n=390) and politicians (n=310), mean age 52 years, answered an electronic questionnaire concerning age-related priority setting in healthcare. The questionnaire had fixed response alternatives with possibility of adding comments. FindingsA majority of the participants thought that age should not influence prioritisation, although more physicians than politicians thought that younger patients should be prioritised. There were also significant differences concerning their views on lifestyle-related diseases and on who should make decisions concerning both vertical and horizontal prioritisation. The comments indicated that the politicians referred to ethical principles as a basis for their standpoints while the physicians often referred to the importance of biological rather than chronological age. Research limitationsWeb-based surveys as a method has its limitations as biased samples and biased returns could cause major problems, such as limited control over the drop-outs. The sample in this study was, however, judged to be representative. 3 Practical implicationsThe results indicate that supplementary guiding principles concerning prioritisation in healthcare are needed in order to facilitate decision-making concerning resource allocation on a local level. The value of the paperThis paper adds important knowledge about decision makers' views on age-related priorities in healthcare, thus contributing to scientific base for prioritisation in healthcare and the ongoing debate in society.

The aims of this paper are to investigate both older people's views about ways in which to finance health-care costs and their willingness to pay for treatment themselves, along with variations in these views by age and gender. The data are from the Good Ageing in Skåne (GAS) prospective longitudinal cohort study in Sweden, which involved medical examinations and a survey of living arrangements and socio-economic conditions. For the analysis reported in this paper, 930 GAS respondents aged 60-93 years were invited to participate in an additional structured interview, and 902 (97 %) accepted. The sample was divided into the ' young-old ' (aged 60-72 years), ' old-old ' (78-84 years) and ' oldest-old ' (87-93 years). It was found that the participants recommended increasing health-care funding by higher taxes and that they were willing to pay themselves for specific treatments, e.g. cosmetic surgery and medication to combat impotence and obesity. Many were also willing to pay privately for cataract surgery, to shorten the wait, although the respondent's financial circumstances associated with this willingness. Significantly more men than women, and of the ' young-old ' than of the other two age groups, would pay for cataract surgery. The views of people aged 85 or more years differed from those of the young-old, e.g. significantly fewer believed that older people's health care received too little resource. Views about how to finance health care thus differed among the age groups and between men and women.