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决策者的优先排序经验以及对如何为医疗保健成本提供资金的看法。

Decision makers' experiences of prioritisation and views about how to finance healthcare costs.

机构信息

Department of Health Sciences, Division of Nursing, Lund University, P-O- Box 157, Se-221 00 Lund, Sweden.

出版信息

Health Policy. 2009 Oct;92(2-3):259-67. doi: 10.1016/j.healthpol.2009.05.007. Epub 2009 May 31.

Abstract

OBJECTIVES

Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians.

METHODS

The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was analysed using both quantitative and qualitative methods.

RESULTS

A majority of the decision makers (55%) suggested that increasing costs should be financed through higher taxation but more physicians than politicians thought that higher patient fees, private health insurance and a reduction in social expenditure were better alternatives. Prioritisation aroused anxiety; politicians were afraid of displeasing voters while physicians were afraid of making medically incorrect decisions.

CONCLUSIONS

This study do not answer the question about how to make prioritisation in health care but the result highlights the different ways that the decision makers view the subject and thereby elicit that publicly elected politicians and physicians perhaps not always work with the same goal ahead. There are needs for more research but also more media focus on the subject so the citizens will be aware and take part in the debate.

摘要

目的

由于资源稀缺,医疗保健中的优先排序问题变得越来越重要。本研究的目的首先是描述决策者在优先排序方面的经验,以及他们对支付意愿和如何为医疗保健成本提供资金的看法。另一个目的是比较政治家和医生的观点。

方法

该研究是一项基于问卷调查的横断面研究,共向 700 名瑞典政治家和医生发放问卷。使用定量和定性方法对其进行分析。

结果

大多数决策者(55%)表示,应通过提高税收来为不断增加的成本提供资金,但与政治家相比,更多的医生认为提高患者费用、私人医疗保险和减少社会支出是更好的选择。优先排序引起了焦虑;政治家担心冒犯选民,而医生则担心做出医疗上不正确的决定。

结论

本研究没有回答如何在医疗保健中进行优先排序的问题,但结果突出了决策者看待这一问题的不同方式,从而表明民选政治家和医生可能并不总是朝着相同的目标努力。需要进一步研究,但也需要更多的媒体关注这一主题,以便公民能够意识到并参与辩论。

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