The Battle of Scare Resources -A Case Study of Prioritization Problems at Sahlgrenska University Hospital

Abstract

Background and Problem: A major problem occurring in the last decades, which is more present now, when money is scarcer than before, is prioritizations by the employees within the health care sector. This problem might be even more present in the future as the population is increasing and aging. Prioritization settings also tend to be more problematic because of the complex structure where many different professions are involved in the prioritization process. The Swedish health care sector is a very emotive subject that affects everyone at some point in life. Hence, ethics seem to play a major role when prioritizations are done. The research question of this study is: Why are prioritization problems in the health care sector problematic and how can the situation be improved? Methodology: To answer our research question we have chosen to do a case study on Sahlgrenska University Hospital. The case study has been done through nine qualitative interviews with managers at different levels in the hierarchy at Sahlgrenska University Hospital. Purpose: Our purpose is to identify and understand problems that arise in the public health care sector when prioritizations have to be done due to scarce resources. Result and Conclusion: During the process, we have identified several problems related to prioritizations. These are scarce resources, prioritization settings, a lack of integration between professions and between specialties, ambiguous directions from the region and a lack of ethical discussions. It is hard to identify a main factor that is the cause of prioritization problems; instead there are many factors contributing to the problematic situation, but we think that better communication within the hospital can improve the situation. Suggestions for further research: • The problem within Region Västra Götaland. Why is it so hard to offer a homogenous health care to the population in the region? • Investigate the prerequisites for a leadership development program at SU. Would it be a good investment? • The National Model of Prioritizations is built on three ethical principles. How can this model be extended or completed to reduce the uncertainty regarding ethical dilemmas?