The Battle of Scare Resources -A Case Study of Prioritization Problems at Sahlgrenska University Hospital

Sammanfattning: Background and Problem:A major problem occurring in the last decades, which is more present now, when money isscarcer than before, is prioritizations by the employees within the health care sector. Thisproblem might be even more present in the future as the population is increasing and aging.Prioritization settings also tend to be more problematic because of the complex structurewhere many different professions are involved in the prioritization process. The Swedishhealth care sector is a very emotive subject that affects everyone at some point in life. Hence,ethics seem to play a major role when prioritizations are done.The research question of this study is:Why are prioritization problems in the health care sector problematic and how can thesituation be improved?Methodology: To answer our research question we have chosen to do a case study onSahlgrenska University Hospital. The case study has been done through nine qualitativeinterviews with managers at different levels in the hierarchy at Sahlgrenska UniversityHospital.Purpose: Our purpose is to identify and understand problems that arise in the public healthcare sector when prioritizations have to be done due to scarce resources.Result and Conclusion: During the process, we have identified several problems relatedto prioritizations. These are scarce resources, prioritization settings, a lack of integrationbetween professions and between specialties, ambiguous directions from the region and a lackof ethical discussions. It is hard to identify a main factor that is the cause of prioritizationproblems; instead there are many factors contributing to the problematic situation, but wethink that better communication within the hospital can improve the situation.Suggestions for further research:• The problem within Region Västra Götaland. Why is it so hard to offer a homogenoushealth care to the population in the region?• Investigate the prerequisites for a leadership development program at SU. Would it bea good investment?• The National Model of Prioritizations is built on three ethical principles. How can thismodel be extended or completed to reduce the uncertainty regarding ethicaldilemmas?