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Table 4 Psychometric properties of novel scarce resource allocation questions

From: Rapid deployment of a community engagement study and educational trial via social media: implementation of the UC-COVID study

 

All

Lay

HCW

Values for prioritization logistics a

0.6066

0.6068

0.6099

 They should try to save the most number of lives possible

0.2787

0.2044

0.4528

 They should take life support away from some patients in order to give it to other patients who are more likely to survive

− 0.0149

− 0.0564

0.0904

 They should make decisions on a first-come, first-served basis

0.0898

0.1244

0.0051

 They should apply the same rules to decide who gets life support to all patients equally

0.7052

0.7183

0.6810

 The same rules should apply to all patients even if they were admitted to the hospital before the crisis started

0.8195

0.8356

0.7709

 The same rules should apply to all patients even if they are in the hospital for reasons that are not related to the disaster or pandemic

0.7888

0.8064

0.7483

 Hospital committees (instead of individual doctors) should make these decisions

0.2057

0.2477

0.1213

 Hospital committees should not know the identities of the patients and use only medical information to make decisions

0.3258

0.3129

0.3712

 Policies like this should be developed with input from patients and community members

0.2393

0.2854

0.1379

Values for prioritization on health factors b

0.7698

0.7594

0.8523

 Patients who are deemed less likely to survive and make it out of the hospital alive

0.6954

0.6777

0.7285

 Patients who have physical or intellectual disabilities

0.5378

0.5096

0.5629

 Patients who have shorter expected lifespans because of chronic illness

0.7769

0.7428

0.8268

 Patients who are elderly

0.6978

0.6962

0.6795

 Patients who are children

− 0.1289

− 0.1233

− 0.1597

 Patients expected to have a poor quality of life if they survive

0.7230

0.7083

0.7906

 Patients expected to need life support for a long time to recover from their illness

0.6569

0.7051

0.6198

 Patients who are chronically dependent on ventilators

  

0.7013

 Patients in persistent vegetative or minimally conscious states

  

0.7965

Values for prioritization on social factors c

0.8809

0.8720

0.8954

 People who are wealthy, famous, or in positions of power (for example: celebrities or politicians)

0.2800

0.1813

0.4841

 People who are a racial or ethnic minority

0.6435

0.6887

0.6315

 People who are LGBTQ+ (e.g, lesbian, gay, bisexual, or transgender)

0.6333

0.6758

0.5865

 People who are prisoners

0.6611

0.6590

0.6786

 People without health insurance

0.6539

0.6511

0.6720

 People who are undocumented immigrants

0.6978

0.7061

0.7012

 Patients who have shorter expected lifespans because of a serious health condition even if that condition is more common among people with a disability

0.7862

0.7662

0.8025

 Patients who have shorter expected lifespans because of a serious health condition even if that condition is more common among racial or ethnic minorities

0.8220

0.8397

0.7876

 Patients who have shorter expected lifespans because of a serious health condition even if that condition is more common among people living in poverty

0.8114

0.8183

0.7923

 People who are philanthropic donors to the hospital or health system

  

0.5067

Values for prioritization exemptions d

0.8284

0.8243

0.8627

 Patients who are pregnant in the first trimester

0.5288

0.5493

0.4904

 Patients who are pregnant in the third trimester

0.5588

0.5889

0.4672

 First responders (for example: police, fire fighters)

0.7526

0.7352

0.7557

 Health care workers in general who are critical to caring for patients

0.8046

0.7981

0.7473

 Health care workers specifically who are on the front lines and at increased risk of harm from the pandemic

0.7802

0.7964

0.6686

 Patients who are participating in medical research studies

0.4851

0.4869

0.5153

 Patients who are the sole or only caregiver of a family member (for example: a child or a disabled or elderly relative)

0.5866

0.5788

0.6019

 Members of the military or veterans

0.6048

0.5858

0.6495

 Public officials (for example: a mayor, governor, president, or congressperson)

0.3931

0.3359

0.5992

 Patients who are on the list to get an organ transplant

0.1984

0.2436

0.2232

 Patients who recently received an organ transplant

0.3876

0.4026

0.4441

 Patients who have recently undergone major surgery (not related to a transplant)

  

0.5039

 Patients who have had a complication from medical care (for example: a procedural or surgical complication or adverse reaction to a medication)

  

0.4420

 Families or friends of critical health workers

  

0.4583

Preferences for policy disclosure e

n/a

0.5795

0.6676

 Hospitals should make this information public so patients like me know what their policy is even if I never have to go to that hospital

0.5655

0.5434

0.3472

 I would want a hospital to tell patients like me about their policy only if I were admitted and in critical condition

− 0.2361

− 0.0380

− 0.0380

 I would consider policies like this when deciding if I would go to a certain hospital

0.4666

0.5397

0.8641

 I would feel more at ease if my doctor verbally explained how a policy like this works

 

0.6488

 

 I would feel more at ease if my doctor provided a written explanation of how a policy like this works

 

0.6744

 

 I would consider policies like this when deciding where I would tell my friends or family to seek care

  

0.9026

 I would consider policies like this when deciding where I would refer my patients for hospital care

  

0.9020

 I would feel comfortable verbally explaining how a policy like this works to patients

  

0.2156

 I would feel comfortable providing a written explanation of how a policy like this works to patients

  

0.2615

 I would feel more comfortable if someone else other than me explained this policy to patients

  

0.1395

 I would be comfortable explaining that a patient had to be taken off of a ventilator due to a policy decision to that patient or their family

  

0.0647

Trust in policy implementation f

0.5666

0.5671

0.7856

 I trust that hospitals and doctors will apply policies like this in a fair and consistent way

0.8725

0.8883

0.7092

 I trust hospitals and doctors to be honest and transparent about how resources are used in a crisis

0.8897

0.8998

0.7316

 I feel anxious or worried when I think about policies like these

− 0.1574

− 0.1805

− 0.1966

 I would trust my doctors to be honest with me about my chances for survival if I were extremely ill or in critical condition

0.5636

0.5854

0.7118

 I feel that I could be honest with a patient about their chances for survival

  

0.5245

 I feel that my colleagues could be honest with a patient about their chances for survival

  

0.6869

 I feel like I could apply policies like this in a fair and consistent way

  

0.7258

 I feel like my colleagues could apply policies like this in a fair and consistent way

  

0.8112

 I feel like my employer would support me if I had to make these types of decisions

  

0.5690

 I feel like I would be distressed or uncomfortable if I had to carry out policies like these

  

− 0.0840

 I feel like I would have adequate legal protection from fallout if I had to carry out policies like these

  

0.3615

 I would have a moral objection to carrying out a policy like this

  

− 0.1630

  1. Standardized factor loadings for each item and Cronbach’s alphas for entire scales (in italics) are shown for the sample overall (“All” column), among a lay (non-HCW) sample (“Lay” column), and among a health care worker (HCW) sample (“HCW” column). Exploratory factor analysis revealed that single factor solutions were appropriate for most scales (Eigenvalues from 0.5933 [for “Preferences for Policy Disclosure” among All respondents] to 4.5293 [for “Values for Prioritization on Social Factors” among HCW] with a median of 2.8018)
  2. aRespondents were asked “Please tell us how you feel hospitals and health care workers should make decisions like these in general.” Items were rated from 1, I strongly disagree with this to 10, I strongly agree with this
  3. bRespondents were asked “How strongly do you feel the following health factors should influence how hospitals and health care workers decide who receives life support during a crisis like a disaster or pandemic?” Items were rated from 1, Should be much less likely to get life support to 5, Should not influence one way or the other to 9, Should be much more likely to get life support
  4. cRespondents were asked “How strongly do you feel the following factors not related to a patient’s health should be considered when making decisions about who should receive life support during a crisis like a disaster or pandemic?” Items were rated from 1, Should be much less likely to get life support to 5, Should not influence one way or the other to 9, Should be much more likely to get life support
  5. dRespondents were asked “There may be some situations where exceptions are made for certain groups of people under policies like this. How strongly do you feel these groups should be considered when making decisions about who should receive life support during a crisis like a disaster or pandemic?” Items were rated from 1, Should be much less likely to get life support to 5, Should not influence one way or the other to 9, Should be much more likely to get life support
  6. eRespondents were asked “How strongly do you agree or disagree with the following statements about how you would prefer to learn about such policies?” Items were rated from 1, I strongly disagree with this to 10, I strongly agree with this. Given that there were only three items similarly available for both lay and HCW samples, overall Cronbach’s alpha is not reported
  7. fRespondents were asked “How strongly do you agree or disagree with the following statement about how policies like this would be applied?” Items were rated from 1, I strongly disagree with this to 10, I strongly agree with this
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ISSN: 1745-6215