Meyer Thorsten
Institut für Sozialmedizin, Universität zu Lübeck/Universitätsklinikum Schleswig-Holstein, 23552 Lübeck.
Z Evid Fortbild Qual Gesundhwes. 2009;103(2):80-4. doi: 10.1016/j.zefq.2009.02.017.
The starting point of the present paper is the different uses of the terms prioritisation and rationing in the debate about resource allocation in health care. Two models of the relationship between prioritisation and rationing are developed. They are intended to contribute to a deeper understanding of the basic concepts. The first model of explicit priority setting assumes deliberate prioritisation which may form the basis of explicit rationing, but also of rationalisation and quality improvements. The second model, representing the rationing perspective, conceives rationing as a societal phenomenon whose implicit prioritisation criteria have to be deduced by means of interpretation. The two models can be distinguished from each other both theoretically and by their application in practice. Some advantages and disadvantages of the models are discussed.
本文的出发点是在医疗保健资源分配的辩论中，“优先排序”和“配给”这两个术语的不同用法。文中提出了优先排序与配给关系的两种模式。旨在有助于更深入地理解这些基本概念。第一种明确设定优先级的模式假定有刻意的优先排序，这可能构成明确配给的基础，同时也是合理化和质量改进的基础。第二种模式代表配给视角，将配给视为一种社会现象，其隐含的优先排序标准必须通过解释来推导。这两种模式在理论上以及在实践中的应用都可以相互区分。文中还讨论了这些模式的一些优缺点。
