The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Table 3 Association between moral foundations subscales and judgments about cost-containment and using cost-effectiveness in clinical practice among 1032 US physicians

	Cost-containment		Cost-effectiveness
	I agree with limiting reimbursement for expensive drugs and procedures if that would help expand access to basic healthcare for those currently lacking such care.		I object to using cost-effectiveness data to determine which treatments will be offered to patients.
	Unadjusted OR	Adjusted OR	Unadjusted OR	Adjusted OR
	(95% CI)	(95% CI)	(95% CI)	(95% CI)
Harm	1.2 (1.0–1.4)*	1.2 (1.0–1.5)*	1.2 (1.0–1.4)*	1.2 (1.0–1.4)
Fairness	1.7 (1.4–2.0)*	1.7 (1.4–2.1)*	0.9 (0.8–1.1)	0.9 (0.7–1.0)
Ingroup	1.0 (0.8–1.1)	1.0 (0.8–1.2)	1.0 (0.9–1.2)	1.0 (0.9–1.2)
Authority	0.9 (0.8–1.0)	0.9 (0.8–1.1)	1.0 (0.9–1.2)	1.0 (0.9–1.2)
Purity	0.9 (0.8–1.0)	1.0 (0.9–1.1)	1.1 (1.0–1.2)	1.1 (1.0–1.2)

Table presents the odds ratios (and 95% confidence intervals) for agreeing with cost containment and objecting to using cost effectiveness data, by scores on each of the five moral foundations subscales. Odds ratios are for one-point increases in subscale score. Multivariable models are adjusted for age, sex, region, and specialty.
* p < 0.05.

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