Alcoholism: Illness beliefs and resource allocation preferences of the public.

Background: Alcohol-dependent patients are at risk of being denied necessary care because of their diagnosis. We sought to find out whether public illness beliefs influence resource allocation decisions of the public, thus putting alcohol-dependent patients at a disadvantage compared to those suffering from other medical and mental disorders.

Method: A telephone survey involving the adult German population was conducted in 2004 (n = 1012). Participants were asked to name three out of nine conditions for which they would prefer resources not to be cut should general cutbacks within the health care budget be necessary. For all conditions we asked about personal attitudes and illness beliefs.

Results: Schizophrenia and alcoholism were chosen least frequently when it was a question of being spared from budget reductions. Compared to other diseases, alcoholism was considered to be particularly self-inflicted and evoked a high desire for social distance. The perceived severity of the disease, the perceived own risk of becoming alcohol dependent, and the notion that alcoholics are themselves responsible for their illness were associated with resource allocation decisions.

Conclusion: Alcohol-dependent patients are at risk of being structurally discriminated within the health care system.