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Werntoft, Elisabet, Hallberg, Ingalill R, Edberg, Anna-Karin. Older People's Reasoning About Age-Related Prioritization in Health Care. Nursing Ethics, May 2007; vol. 14: pp. 399-412

The aim of this study was to describe the reasoning of people aged 60 years and over about prioritization in health care with regard to age and willingness to pay. Healthy people (n = 300) and people receiving continuous care and services (n = 146) who were between 60 and 101 years old were interviewed about their views on prioritization in health care. The transcribed interviews were analysed using manifest and latent qualitative content analysis. The participants' reasoning on prioritization embraced eight categories: feeling secure and confident in the health care system; being old means low priority; prioritization causes worries; using underhand means in order to be prioritized; prioritization as a necessity; being averse to anyone having precedence over others; having doubts about the distribution of resources; and buying treatment requires wealth.
 

Dey, Ian, Fraser, Neil. Age-Based Rationing in the Allocation of Health Care. J Aging Health, Nov 2000; vol. 12: pp. 511-537

Objectives:This article seeks to review debates about age-based rationing in health care. Methods:The article identifies four different levels (or types) of decisionmaking in health resource allocation--societal, strategic, programmatic, and clinical-- and assesses how the issues of rationing vary in relation to each level. Results:The article concludes that rationing is least defensible at the clinical level, where it is also most covert. The role of rationing at other levels is more defensible when based on grounds of cost-effectiveness rather than equity. The article emphasizes the importance of fairness in health allocation and suggests that efficiency criteria need to be considered in that context. Discussion:The article suggests that rationing is most problematic where it is least overt. This raises further questions about how rationing can be made more explicit at different levels of decision making.
 

Mary Simms. Opening the Black Box of Rationing Care in Later Life: The Case of `Community Care' in Britain. J Aging Health 2003 15: 713

Research on the rationing of care to older patients in Britain and America typically focuses on acute care here I consider `chronic care'as illustrated by `community care' in Britain. Adopting a critical sociological approach to dependency and to the construction of `later life,'I argue that chronic care users constitute a class, and that clinical need has played a pivotal role in its development. As this reflects the allocative rationing of care I call into question, the claim made by the current British government that needcan provide a benchmark of age justice.