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[人道主义与竞争之间的医学:患者视角]

[Medicine between humanitarianism and competition: the patients' point of view].

作者信息

Krones C J, Rosch R, Steinau G, Schumpelick V

机构信息

Klinik und Poliklinik für Chirurgie, RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Deutschland.

出版信息

Chirurg. 2008 Sep;79(9):859-65. doi: 10.1007/s00104-008-1555-1.

Abstract

BACKGROUND

An open medical market is supposed to be a promising tool for preserving the meagre resources of the German public health care system. The competition between humane and economic practice induces conflicts which burden physicians as well as patients. To analyse this problem by scientific means, inpatients were interviewed with the help of a standardised protocol.

PATIENTS AND METHODS

During 10 weeks 524 inpatients were interviewed. The structured questionnaire consisted of nine closed-ended questions with multiple-choice answers. Question 3 included a free amendment. The gender ratio was balanced, and the age pattern represented the typical patient collective of our clinic.

RESULTS AND CONCLUSION

The majority of patients expect negative changes in their medical service and the social attitude towards patients and physicians due to promoted medical competition. Besides an increasing financial load, losses in trust, self-determination, and therapeutic freedom are expected. Instead a responsible transparency will not be achieved. Patients still judge the economically dominated reforms on the German health care market with scepticism or even hostility. In their point of view future discussions must aim at a more modern attitude towards health economics in order to bridge the schism they perceive between medical competition and humanitarianism. The understanding of strong financial management as a prime condition for stable social security is the basis of synergies to deal with upcoming reforms.

摘要

背景

开放的医疗市场被认为是保护德国公共医疗系统稀缺资源的一种有前景的手段。人文医疗与经济利益之间的竞争引发了冲突,给医生和患者都带来了负担。为了用科学方法分析这个问题,我们借助标准化方案对住院患者进行了访谈。

患者与方法

在10周内,我们对524名住院患者进行了访谈。结构化问卷由9个封闭式多项选择题组成。问题3包含一个自由补充项。性别比例均衡,年龄分布代表了我们诊所的典型患者群体。

结果与结论

大多数患者预计,由于医疗竞争加剧,他们所接受的医疗服务以及社会对患者和医生的态度会出现负面变化。除了经济负担加重外,他们还预计信任、自主决定权和治疗自由度会丧失。相反,无法实现负责任的透明度。患者仍然对德国医疗市场上以经济利益为主导的改革持怀疑甚至敌对态度。在他们看来,未来的讨论必须着眼于对健康经济学采取更现代的态度,以弥合他们所察觉到的医疗竞争与人道主义之间的分歧。将强大的财务管理理解为稳定社会保障的首要条件,是应对即将到来的改革实现协同效应的基础。

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