Botten G, Aasland O G
Senter for helseadministrasjon Universitetet i Oslo, Rikshospitalet.
Tidsskr Nor Laegeforen. 2000 Oct 20;120(25):2995-9.
The challenge of finding ways of allocating public health resources is much debated. Many argue that the public should play a major role in deciding what services should be delivered and paid for. The aim of this study was to collect information on the public opinion on various health policy issues.
A representative sample of 1,342 Norwegians was interviewed in 1998 about their attitudes towards various health policy issues.
The results showed that Norwegians have great expectations of the national health services. The majority wants immediate access, free choice, and minimal out-of-pocket payments. Factor analysis yielded four latent variables in the response pattern: economic rationing, market-orientation, access and out-of-pockets payment. Women were less in favour of economic rationing, less market-oriented and wanted more influence than men. Free access to services grew more important by age. Politically conservative voters were most in favour of market-orientation.
To involve the public in priority issues is hard, as their expectations are extensive and contradicting. However, it is most important to involve them in order to establish the understanding that public health services cannot supply everything free of charge to everyone.
如何分配公共卫生资源这一挑战引发了诸多讨论。许多人认为,公众在决定应提供哪些服务以及由谁付费方面应发挥主要作用。本研究旨在收集有关公众对各种卫生政策问题看法的信息。
1998年,对1342名具有代表性的挪威人进行了访谈,询问他们对各种卫生政策问题的态度。
结果显示,挪威人对国家医疗服务寄予厚望。大多数人希望能立即获得服务、自由选择且自付费用最低。因子分析在回应模式中得出四个潜在变量:经济配给、市场导向、服务可及性和自付费用。与男性相比,女性不太支持经济配给,市场导向性较低,且希望拥有更大影响力。随着年龄增长,免费获得服务变得愈发重要。政治上保守的选民最支持市场导向。
让公众参与优先事项很困难,因为他们的期望广泛且相互矛盾。然而,为了让人们明白公共卫生服务无法为每个人免费提供一切,让公众参与进来至关重要。