Abstract
BACKGROUND: Our objective is to study the differences and similarities in public healthcare priority setting attitudes among Finnish physicians, dentists, members of the parliament (MPs), and citizens. Additionally, we explore the correlation of socio-demographic factors with attitudes among the citizens. A comprehensive study including the views of all relevant stakeholder groups has been lacking, and the attitudes of dentists and parliamentarians have not been studied previously. METHODS: Our study design employs a cross-sectional survey and comparative analysis to examine the attitudes of citizens, physicians, dentists, and MPs. The online attitude surveys were conducted in Finland between January and March 2022. The survey sample consisted of 1,500 physicians (240 answered), 500 dentists (177), 200 MPs (27) and 2,794 citizens (1,001). Using Pandas for cross-tabulation and the Pearson Chi-square test for significance at a 95% confidence level, we compared attitudes across stakeholder groups and demographic variables like age, gender, and income. We measured the strength of relationships using Cramer’s V, considering only effects larger than 0.10 to be meaningful. RESULTS: We found significant differences in priority setting attitudes among physicians, dentists, MPs, and citizens. Physicians and dentists were more accepting, while citizens had a more negative attitude. In terms of specific priority setting principles, the most significant differences between stakeholder groups were related to views on individuals’ health behaviour. The study also revealed differences between physicians and dentists. Citizens, especially more vulnerable groups, had a more negative attitude towards priority setting in general compared to specific principles. Age, education, labour market position and income had a weak but significant association with citizens’ attitudes towards priority setting. CONCLUSIONS: We found that citizens’ attitudes towards prioritising and rationing health services differ significantly from those of healthcare professionals and politicians. The results emphasise the complex nature of the priority setting debate and draw attention to how different groups are involved in healthcare decision-making and methods used for their inclusion. The findings encourage facilitating discussions among stakeholders to inform them of the realities and advantages of priority setting, thereby increasing its acceptability and legitimacy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25559-y.