Vogt Florian, Schwappach David L B, Bridges John F P
International Health Economics and Outcomes Research, Department of Tropical Hygiene and Public Health, University of Heidelberg - Medical School, Heidelberg, Germany.
Pharmacoeconomics. 2006;24(5):419-23. doi: 10.2165/00019053-200624050-00001.
Internationally, there has been a movement in medicine to better involve patients in decision making, whether it be at the individual or aggregate level. However, the German health sector has been slow to understand and accommodate the preferences of patients. This paper discusses the reasons why and attempts to highlight some of the consequences of not involving patients in healthcare decision making within the German context. We argue that a fundamental paradigm shift at all levels of the German health system, including better doctor/patient communication, is necessary for more choices to be available to patients and to better reflect patient preferences in centralised healthcare decision making. The newly created German health technology assessment agency (IQWiG; Institute for Quality and Economic Efficiency in the Health Care Sector) has indicated that they are interested in focusing on patient preferences, but there is a need for them to clarify what methods they deem suitable for doing so.
在国际上，医学领域出现了一种趋势，即让患者更好地参与决策，无论是在个体层面还是总体层面。然而，德国医疗部门在理解和顺应患者偏好方面进展缓慢。本文探讨了其中的原因，并试图强调在德国背景下不让患者参与医疗保健决策的一些后果。我们认为，德国医疗体系的各个层面都需要进行根本性的范式转变，包括改善医患沟通，以便为患者提供更多选择，并在集中式医疗保健决策中更好地反映患者偏好。新成立的德国卫生技术评估机构（IQWiG；医疗保健领域质量与经济效率研究所）表示，他们有兴趣关注患者偏好，但他们需要阐明他们认为适合这样做的方法。
