Health care administration

Health: watch out for age discrimination

A team of Canadian and American researchers asked people on the street to approve or reject budget priorities for different interventions based on the average age of patients: 35 years or 65 years. They very clearly favoured young people for treatment of infertility or organ transplants. For the treatment of depression or palliative care, age no longer appeared to be a decisive factor.

“For them, age was not a factor for some types of care,” explains Mira Johri, a professor in the Department of Health Care Administration at University of Montréal. According to the majority of the 147 respondents in this survey (all the Americans were recruited at University of Michigan), the age of the patient should be taken into account for life-saving interventions, but hospitals should not deprive the elderly of treatments designed to improve quality of life.

In health economics, the high cost of some kinds of care is cited to justify denying them to the elderly, since they have fewer years left to live. “The economists take two different approaches,” explains Mrs. Johri. “The first is based on productivity as a function of age (agism productivity), which means that the social and economic productivity of the patient is taken into account; the second is based on equitable administration of care without consideration for productivity.”

The findings of this investigation could shake up health economics, where many measures are formulated based on efficiency and productivity. “Cost-benefit analyses lead to an assessment in which one seeks to measure all the repercussions associated with different options and find the combination of programs with maximum impact,” the report reads. “Age can be a determining factor because older patients are less likely to benefit from an intervention in the long term than younger patients.”

The researcher, who studied ethics and political philosophy with Charles Taylor at McGill University before being hired by the Faculty of Medicine at University of Montréal, has been looking at opinion polls on health policies for some time. She has noted some faults. “In these polls, public opinion greatly favours the treatment of younger people,” explains the researcher. “But we feel that there is a bias in these investigations; the questions are generally about cases of life or death, such as organ transplants.”