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A Survey of Australian Public Opinion on Using Comorbidity to Triage Intensive Care Patients in a Pandemic

Winston Cheung, Vasi Naganathan, John Myburgh, Manoj Saxena, Blyth Fiona, Ian Seppelt, Michael Parr, Claire Hooker, Ian Kerridge, Nhi Nguyen, Sean Kelly, George Skowronski, Naomi Hammond, Antony Attokaran, Debbie Chalmers, Kalpesh Gandhi, Mark Kol, Shay McGuinness, Priya Nair, Vineet Nayyar, Neil Orford, Rachael Parke, Asim Shah, Atul Wagh

Abstract

Objectives: To determine which method to triage intensive care patients using chronic comorbidity in a pandemic was perceived to be the fairest by the general public. Secondary objectives were to determine whether the public perceived it fair to provide preferential intensive care triage to vulnerable or disadvantaged people, and frontline healthcare workers. Methods: Postal survey of 2000 registered voters randomly selected from the Australian Electoral Commission electoral roll. The main outcome measures were respondents’ fairness rating of four hypothetical intensive care triage methods that assess comorbidity (chronic medical conditions, long-term survival, function, and frailty); and respondents’ fairness rating of providing preferential triage to vulnerable or disadvantaged people, and frontline healthcare workers. Results: The proportion of respondents who considered it fair to triage based on chronic medical conditions, long-term survival, function, and frailty, was 52.1%, 56.1%, 65.0% and 62.4%, respectively. The proportion of respondents who considered it unfair to triage based on these four comorbidities was 31.9%, 30.9%, 23.8%, 23.2%, respectively. More respondents considered it unfair to preferentially triage vulnerable or disadvantaged people, than fair (41.8% versus 21.2%). More respondents considered it fair to preferentially triage frontline health care workers, than unfair (44.2% versus 30.0%). Conclusion: Respondents in this survey perceived all four hypothetical methods to triage intensive care patients based on comorbidity in a pandemic disaster to be fair. However, the sizable minority who consider this to be unfair indicates that these triage methods could encounter significant opposition if they were to be enacted in health policy.

AH23265  Accepted 15 April 2024

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