Patients’ Willingness to Share Limited Endoscopic Resources: A Brief Report on the Results of a Large Regional Survey

Author:

Piper Marc S.12ORCID,Zikmund-Fisher Brian J.34ORCID,Maratt Jennifer K.1567,Kurlander Jacob18,Metko Valbona1,Waljee Akbar K.18,Saini Sameer D.18

Affiliation:

1. Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan

2. Division of Gastroenterology, Department of Internal Medicine, Providence Park Hospital, Michigan State University College of Human Medicine, Southfield, Michigan

3. Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan

4. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan

5. Division of Gastroenterology, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana

6. Richard L. Roudebush VA Medical Center, Indianapolis, Indiana

7. Regenstrief Institute, Inc, Indianapolis, Indiana

8. VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan

Abstract

Background. In some health care systems, patients face long wait times for screening colonoscopy. We sought to assess whether patients at low risk for colorectal cancer (CRC) would be willing to delay their own colonoscopy so higher-risk peers could undergo colonoscopy sooner. Methods. We surveyed 1054 Veterans regarding their attitudes toward repeat colonoscopy and risk-based prioritization. We used multivariable regression to identify patient factors associated with willingness to delay screening for a higher-risk peer. Results. Despite a physician recommendation to stop screening, 29% of respondents reported being “not at all likely” to stop. However, 94% reported that they would be willing to delay their own colonoscopy for a higher-risk peer. Greater trust in physician and greater health literacy were positively associated with willingness to wait, while greater perceived threat of CRC and Black or Latino race/ethnicity were negatively associated with willingness to wait. Conclusion. Despite high enthusiasm for repeat screening, patients were willing to delay their own colonoscopy for higher-risk peers. Appealing to altruism could be effective when utilizing scarce resources.

Funder

Health Services Research and Development

National Institutes of Health

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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