医疗保健中的优先排序与资源分配：接受持续公共护理和服务的老年人的观点。
Prioritization and resource allocation in health care: the views of older people receiving continuous public care and service.
作者信息
Werntoft Elisabet, Hallberg Ingalill R, Edberg Anna-Karin
机构信息
Department of Health Sciences, and Lund University, Lund, Sweden.
出版信息
Health Expect. 2007 Jun;10(2):117-28. doi: 10.1111/j.1369-7625.2006.00426.x.
OBJECTIVE
To describe the views of people, 65 years and over, receiving continuous public care and service, on prioritization and resource allocation in health care, in relation to gender, age, housing, health-related quality of life (QoL) and degree of activities of daily living (ADL) dependency.
BACKGROUND
How older people receiving continuous public care and service view prioritization and resource allocation in health care is sparsely investigated, although this group most certainly has the experience and also often is the target in discussions concerning prioritization. It is necessary, for democracy and for the development of new models of service delivery, to find out how people receiving long-term care and service view these issues.
DESIGN
146 persons, 34 men (23%) and 112 women (77%), aged 66-100 years were interviewed face to face, following a structured questionnaire.
RESULTS
The respondents thought that the patients' well-being, way of living and family situation should affect prioritization, not age per se. Resourcing of several health-care services were considered to be below what is required by a majority of the respondents. The respondents wanted doctors to decide on prioritization at an individual level and wanted higher taxes to finance increasing health-care costs. Although the respondents wanted publicly financed health care, a relatively high number were willing to pay for treatment.
CONCLUSIONS
Knowledge of how older people receiving care and services, view prioritization and resource allocation has not previously been available. It seems that their views are in line with the Swedish Parliamentary Priority Commission which suggested that no account should be taken of age when allocating resources within the health-care system. Respondents' age, gender, housing, health-related QoL and degree of dependency in ADL had limited influence on their views of resource allocation.
目的
描述65岁及以上接受持续公共护理和服务的人群对医疗保健中的优先事项确定和资源分配的看法，涉及性别、年龄、住房、健康相关生活质量（QoL）和日常生活活动（ADL）依赖程度。
背景
尽管接受持续公共护理和服务的老年人在医疗保健优先事项确定方面肯定有经验，且往往是相关讨论的对象，但对他们如何看待医疗保健中的优先事项确定和资源分配的研究却很少。为了民主以及新服务提供模式的发展，有必要了解接受长期护理和服务的人群对这些问题的看法。
设计
采用结构化问卷，对146名年龄在66 - 100岁之间的人员进行了面对面访谈，其中男性34人（23%），女性112人（77%）。
结果
受访者认为患者的幸福、生活方式和家庭状况应影响优先事项确定，而非年龄本身。多数受访者认为多项医疗保健服务的资源配置低于所需水平。受访者希望医生在个体层面决定优先事项，并希望提高税收以支付不断增加的医疗保健费用。尽管受访者希望医疗保健由公共资金提供，但仍有相对较高比例的人愿意为治疗付费。
结论
此前尚缺乏关于接受护理和服务的老年人如何看待优先事项确定和资源分配的知识。他们的观点似乎与瑞典议会优先事项委员会一致，该委员会建议在医疗保健系统内分配资源时不应考虑年龄。受访者的年龄、性别、住房、健康相关生活质量和ADL依赖程度对其资源分配观点的影响有限。
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