医疗保健决策中的公正性：患者对医疗保健提供者和健康计划代表的评价
Justice in health care decision-making: patients' appraisals of health care providers and health plan representatives.
作者信息
Fondacaro Mark, Frogner Bianca, Moos Rudolf
机构信息
Department of Psychology, University of Florida, Psychology Building, Room 220, PO Box 112250, Gainesville, FL 32611-2250, USA.
出版信息
Soc Justice Res. 2005 Mar;18(1):63-81. doi: 10.1007/s11211-005-3393-3.
This study describes the development of two versions of a Health Care Justice Inventory (HCJI). One version focuses on patients' interactions with their providers (HCJI-P) and the other focuses on patients' interactions with the representatives of their health plans (HCJI-HP). Each version of the HCJI assesses patients' appraisals of their interactions (with either their Provider or representatives of their Health Plan) along three common dimensions of procedural justice: Trust, Impartiality, and Participation. Both the Provider and Health Plan scales assess indices that are relatively independent of patients' demographic characteristics. In addition, patients' appraisals of their interactions with their provider were only moderately related to their appraisals of their interactions with representatives of their health plan, indicating that the Provider and Health Plan scales tap distinct aspects of patients' overall experience with the health care system. Overall, procedural justice dimensions were significantly related to patient satisfaction in both the Provider and the Health Plan contexts. As predicted, procedural justice factors were more strongly tied to patient satisfaction in the provider than in the Health Plan context, and health care decisions based on distributive justice principles of Need (rather than Equity or Equality) were most closely tied to patient satisfaction in both contexts.
本研究描述了医疗保健正义量表（HCJI）两个版本的开发情况。一个版本聚焦于患者与医疗服务提供者的互动（HCJI-P），另一个版本聚焦于患者与健康计划代表的互动（HCJI-HP）。HCJI的每个版本都从程序正义的三个共同维度评估患者对其互动（与医疗服务提供者或健康计划代表）的评价：信任、公正和参与。医疗服务提供者量表和健康计划量表都评估相对独立于患者人口统计学特征的指标。此外，患者对与医疗服务提供者互动的评价与对与健康计划代表互动的评价仅有适度关联，这表明医疗服务提供者量表和健康计划量表挖掘了患者在医疗保健系统整体体验中的不同方面。总体而言，在医疗服务提供者和健康计划背景下，程序正义维度与患者满意度均显著相关。正如预测的那样，与健康计划背景相比，程序正义因素在医疗服务提供者背景下与患者满意度的联系更为紧密，并且基于需求（而非公平或平等）的分配正义原则做出的医疗保健决策在两种背景下都与患者满意度联系最为紧密。
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