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医生和政治家关于医疗保健中与年龄相关的优先排序的观点。

The views of physicians and politicians concerning age-related prioritisation in healthcare.

作者信息

Werntoft Elisabet, Edberg Anna-Karin

机构信息

Department of Health Sciences, Lund University, Lund, Sweden.

出版信息

J Health Organ Manag. 2009;23(1):38-52. doi: 10.1108/14777260910942542.

Abstract

PURPOSE

The aim of this study is to describe the view of age-related prioritisation in health care among physicians and healthcare politicians and to compare their views regarding gender and age.

DESIGN/METHODOLOGY/APPROACH: Swedish physicians (n=390) and politicians (n=310), mean age 52 years, answered an electronic questionnaire concerning age-related priority setting in healthcare. The questionnaire had fixed response alternatives with possibility of adding comments.

FINDINGS

A majority of the participants thought that age should not influence prioritisation, although more physicians than politicians thought that younger patients should be prioritised. There were also significant differences concerning their views on lifestyle-related diseases and on who should make decisions concerning both vertical and horizontal prioritisation. The comments indicated that the politicians referred to ethical principles as a basis for their standpoints while the physicians often referred to the importance of biological rather than chronological age.

RESEARCH LIMITATIONS/IMPLICATIONS: Web-based surveys as a method has its limitations as biased samples and biased returns could cause major problems, such as limited control over the drop-outs. The sample in this study was, however, judged to be representative.

PRACTICAL IMPLICATIONS

The results indicate that supplementary guiding principles concerning prioritisation in healthcare are needed in order to facilitate decision-making concerning resource allocation on a local level.

ORIGINALITY/VALUE: This paper adds important knowledge about decision makers' views on age-related priorities in healthcare, thus contributing to scientific base for prioritisation in healthcare and the ongoing debate in society.

摘要

目的

本研究旨在描述医生和医疗保健政策制定者对医疗保健中与年龄相关的优先排序的看法,并比较他们在性别和年龄方面的观点。

设计/方法/途径:瑞典的医生(n = 390)和政策制定者(n = 310),平均年龄52岁,回答了一份关于医疗保健中与年龄相关的优先排序的电子问卷。问卷有固定的回答选项,并可添加评论。

研究结果

大多数参与者认为年龄不应影响优先排序,尽管认为应优先考虑年轻患者的医生比政策制定者更多。他们在与生活方式相关的疾病以及应由谁做出纵向和横向优先排序的决策方面也存在显著差异。评论表明,政策制定者将伦理原则作为其立场的基础,而医生则经常提及生物学年龄而非实际年龄的重要性。

研究局限性/影响:基于网络的调查作为一种方法有其局限性,因为有偏差的样本和有偏差的回复可能会导致重大问题,例如对退出者的控制有限。然而,本研究中的样本被认为具有代表性。

实际意义

结果表明,需要有关医疗保健优先排序的补充指导原则,以便于在地方层面进行资源分配的决策。

原创性/价值:本文增加了关于决策者对医疗保健中与年龄相关的优先事项的看法的重要知识,从而为医疗保健中的优先排序的科学基础和社会上正在进行的辩论做出了贡献。

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