Who wants to know if their care is rationed? Views of citizens and service informants.

OBJECTIVE: To explore the views of citizens and service informants about whether they would want to know about any rationing of their own health care.
DESIGN: In-depth interviews using a semistructured schedule. Data were analysed using the methods of constant comparison. SETTING AND PARTICIPANTS: Citizens and service informants. MAIN VARIABLES STUDIED: Issues around health care rationing were explored within the context of the United Kingdom health care system.
RESULTS: The views of citizens and service informants were very similar in terms of whether they, personally, wanted to know about any rationing of their own care, with the vast majority wanting to be given this information. Informants were also similar in terms of their reasons for wanting to know about rationing: to be given a 'good explanation' to enable them to judge whether the decision made had been correct; and to enable them to change the decision if necessary, either through protest or payment. Many informants suggested that they would indeed be likely to react either by challenging the decision or by paying for care.
CONCLUSIONS: The findings suggest that policies to be open with people about the rationing of care would be welcomed, but also indicate that if protest follows such openness, it may be difficult for the health service to cope with greater explicitness. Further research is needed among patient groups actually facing this situation.