Vashdi Dana R, Zalmanovitch Yair
LecturerSenior Lecturer, Division of Public Administration and Policy, School of political Sciences, University of Haifa, Haifa, Israel.
Health Expect. 2014 Aug;17(4):593-601. doi: 10.1111/j.1369-7625.2012.00790.x. Epub 2012 Jun 28.
In a time of economic austerity, one of the most daunting questions is who decides on healthcare rationing? In the current study, we sought to examine if the public can in fact provide meaningful information regarding healthcare policy issues. Based on theories of public policy, this paper tries to find out if patients behave akin to 'responsible citizens' and can provide differentiated expectations between three healthcare dimensions.
One thousand two-hundred eleven individuals participated in a telephone interview. Participants were asked two series of questions, one regarding their views on the primary care, prevention and promotion practices they experience with their healthcare provider and one regarding the importance of these practices to them. We calculated a difference score representing the gap in each healthcare dimension.
In all three healthcare dimensions, the mean gap is in the positive side of the axis indicating that the public does not receive what it expects to receive, or in policy terms there is 'a responsiveness deficit'. The mean gap in relation to primary care is significantly lower than the mean gap in both preventive care and health promotion.
The public can provide meaningful information even in areas of endless demand and can provide an addition point of view to be considered by policy makers in complicated healthcare rationing decisions.
在经济紧缩时期，最令人望而生畏的问题之一是谁来决定医疗资源的分配？在当前的研究中，我们试图检验公众是否实际上能够提供有关医疗政策问题的有意义信息。基于公共政策理论，本文试图弄清楚患者的行为是否类似于“有责任感的公民”，以及能否在三个医疗维度之间提供不同的期望。
1211个人参与了电话访谈。参与者被问及两组问题，一组是关于他们对与医疗服务提供者的初级保健、预防和促进措施的看法，另一组是关于这些措施对他们的重要性。我们计算了一个差异分数，代表每个医疗维度的差距。
在所有三个医疗维度中，平均差距都在坐标轴的正值一侧，这表明公众没有得到他们期望得到的东西，或者从政策角度来说，存在“响应不足”。与初级保健相关的平均差距明显低于预防保健和健康促进方面的平均差距。
即使在需求无止境的领域，公众也能提供有意义的信息，并能为政策制定者在复杂的医疗资源分配决策中提供一个额外的考虑视角。
