Profiling Decision-Making Styles Under Healthcare Resource Scarcity: An Interdisciplinary Clustering Approach

Abstract

Scarcity of healthcare resources requires prioritisation decisions that raise complex ethical, economic, and social challenges. While normative frameworks provide guidance on how such decisions ought to be made, growing evidence suggests that individuals differ substantially in how they approach morally charged allocation choices. This study investigates heterogeneity in decision-making styles and support for healthcare prioritisation criteria using an interdisciplinary approach that integrates health economics, social psychology, and computational methods to identify latent decision-making profiles among a sample of adults residing in Portugal. Data were collected from adults residing in Portugal using a structured online questionnaire comprising socio-demographic characteristics, decision-making styles, and preferences elicited through twenty hypothetical healthcare rationing scenarios. The results reveal three meaningful decision-making profiles characterised by different combinations of cognitive styles and ethical prioritisation patterns: analytically oriented decision-makers prioritising health gains; intuitive, context-sensitive decision-makers balancing clinical and social criteria; heuristic-driven decision-makers relying on simpler or less differentiated heuristics. These findings demonstrate that, within this sample, healthcare prioritisation preferences are shaped by systematic variations in decision style rather than a single moral or rational framework. By linking behavioural heterogeneity with ethical decision-making, this study contributes to theoretical debates on healthcare rationing and demonstrates the value of clustering techniques for uncovering latent structures in complex decision data. The results provide insights relevant for the design of decision-support systems and rationing policies, which may be adapted to accommodate heterogeneous decision styles in comparable settings.