![]() Priorities are often set through a process of decision-making. We define priority setting in health care as the ranking of health services and the ranking of recipients of these services. In so doing, clinicians must balance the two roles of being patient advocates and gatekeepers of resources. ![]() While politicians and policymakers make decisions for large patient groups and future patients, clinicians have to occasionally deny a person in front of them beneficial, and in some cases, vital treatment. All health care systems therefore have to set priorities. The practice of medicine is resource intensive and there is always a gap between demand and supply. The consequences for patients and the professionals are substantial. Physicians encounter numerous dilemmas due to resource scarcity, and they report they lack adequate guidance for how to handle them. ![]() This study provides the first glimpses of the untold story of resource shortage and bedside rationing in Ethiopia. Almost 9 out of 10 physicians were so troubled by limited resources that they often regretted their choice of profession. Almost all respondents had witnessed different adverse consequences of resource scarcity 54 % reported seeing patients who, in their estimation, had died due to resource scarcity. Availability of institutional or national guidelines for whom to see and treat first was lacking. The most common rationing strategies used daily or weekly were limiting laboratory tests, hospital drugs, radiological investigations and providing second best treatment (47, 47, 47 and 39 % respectively). The services most frequently reported to be in short supply, either daily or weekly, were access to surgery, specialist and intensive care units, drug prescriptions and admission to hospital (52, 49, 46, 47 and 46 % respectively). The majority had experienced system-wide shortages of various types of medical services. In total, 587 physicians responded (91 % response rate). Data were weighted and analyzed using descriptive statistics. All physicians in the selected hospitals were invited to respond to a self-administered questionnaire. MethodsĪ national survey was conducted amongst physicians from 49 public hospitals using stratified, multi-stage sampling in six regions. Here we describe physicians’ experiences regarding scarcity of resources, bedside rationing, use of various strategies to save resources, and perceptions of the consequences of rationing in Ethiopia. However, little is known about physicians’ experiences in resource-limited contexts in low- income countries. In high-income settings, bedside rationing is commonly discussed and debated as a means to addressing scarcity. Resource scarcity in health care is a universal challenge.
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