Brennan David S, Singh Kiran A, Spencer A John
Australian Research Centre for Population Oral Health, School of Dentistry, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia.
Health Policy. 2008 May;86(2-3):318-24. doi: 10.1016/j.healthpol.2007.11.008. Epub 2008 Feb 21.
To describe the social and health system values of dentists, examine the associations of essential and instrumental health system values and social values with health system values.
A random sample of Australian dentists was surveyed by mailed self-complete questionnaires in 2004 (response rate=72%, n=191).
A minority agreed with egalitarian social values (19%), while the majority endorsed the essential health system values of fair access (84%), quality of care (93%), efficiency (82%), respect for patients (90%) and patient advocacy (81%). A minority agreed with the instrumental health system values of personal responsibility (48%) and social solidarity (45%), but a majority agreed with social advocacy (73%), provider autonomy (95%), consumer sovereignty (91%) and personal security (65%). The strongest associations between essential values and instrumental values (P<0.05) were observed between the essential value of fair access and the instrumental values of social advocacy (rho=0.51) and social solidarity (rho=0.43). Egalitarian values were associated with [odds ratio; 95% CI] the essential value of fair access (2.35; 1.24-4.45) and the instrumental value of social solidarity (2.39; 1.31-4.34).
Dentists endorsed essential health system values, but varied in their support for instrumental health system values. A minority endorsed egalitarian values, which were positively associated with the essential value of fair access and the instrumental value of social solidarity. It is important to consider the role of values of key stakeholders such as providers and patients in health policy development.
描述牙医的社会和卫生系统价值观，研究基本和工具性卫生系统价值观及社会价值观与卫生系统价值观之间的关联。
2004年通过邮寄自填式问卷对澳大利亚牙医进行随机抽样调查（回复率=72%，n=191）。
少数人认同平等主义社会价值观（19%），而多数人认可公平可及性（84%）、医疗质量（93%）、效率（82%）、尊重患者（90%）和患者权益倡导（81%）等基本卫生系统价值观。少数人认同个人责任（48%）和社会团结（45%）等工具性卫生系统价值观，但多数人认同社会倡导（73%）、提供者自主性（95%）、消费者主权（91%）和个人安全（65%）。在公平可及性这一基本价值观与社会倡导（rho=0.51）和社会团结（rho=0.43）这两个工具性价值观之间观察到基本价值观与工具性价值观之间最强的关联（P<0.05）。平等主义价值观与公平可及性这一基本价值观[比值比；95%置信区间]（2.35；1.24 - 4.45）以及社会团结这一工具性价值观（2.39；1.31 - 4.34）相关。
牙医认可基本卫生系统价值观，但对工具性卫生系统价值观的支持程度各不相同。少数人认可平等主义价值观，其与公平可及性这一基本价值观以及社会团结这一工具性价值观呈正相关。在卫生政策制定中考虑提供者和患者等关键利益相关者的价值观作用很重要。
