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跨境流动与社交网络:在泰老边境寻求医疗的老挝人。

Cross-border mobility and social networks: Laotians seeking medical treatment along the Thai border.

机构信息

Department of Geography, University Paris Ouest Nanterre la Défense, Mosaïques UMR Lavue, 200 Avenue de la République, 92001 Nanterre, France.

出版信息

Soc Sci Med. 2015 Jan;124:364-73. doi: 10.1016/j.socscimed.2014.10.022. Epub 2014 Oct 12.

Abstract

Drawing upon research conducted on cross-border patients living in Laos and seeking care in Thailand, this paper examines the important role played by social networks in patients' decision-making and on the itineraries they choose to seek treatment on the Thai side of the border. Due to the vastly contrasting situations between the two countries in terms of healthcare supply, and considering Laotians' increasing demand for high quality healthcare, a number of them have managed to satisfy their needs by combining cross-border treatment with the use of the healthcare facilities provided by their own country. This study consisted first of household surveys conducted in five border areas (2006-2007) in Laos in order to quantify and map out cross-border healthcare-related travel patterns. Afterwards, interviews were conducted with cross-border patients (55), Laotian and Thai medical doctors (6), Thai social workers (5), and officials working in public institutions (12). While socioeconomic and spatial factors partly explain cross-border mobility, patients' social networks significantly influence treatment itineraries throughout the decision-making process, including logistical and financial considerations. The social networks existing at different geographical levels (neighbourhood, regional and global) are therefore a powerful analytical tool not only for understanding the emergence of these cross-border movements but also for justifying them in an authoritarian political environment such as Lao PDR's.

摘要

本文以居住在老挝并前往泰国寻求医疗服务的跨境病患为研究对象,探讨了社会网络在病患就医决策和跨境就医行程选择中的重要作用。由于两国医疗资源供应情况存在显著差异,同时考虑到老挝民众对高质量医疗服务的需求不断增长,一些人通过跨境就医与本国医疗设施相结合的方式,成功满足了自身需求。本研究首先在老挝五个边境地区(2006-2007 年)进行了家庭调查,以量化和绘制跨境医疗相关旅行模式。随后,对跨境病患(55 人)、老挝和泰国医生(6 人)、泰国社工(5 人)和公共机构工作人员(12 人)进行了访谈。虽然社会经济和空间因素部分解释了跨境流动,但病患的社会网络在整个决策过程中对治疗行程产生了重大影响,包括后勤和财务方面的考虑。因此,存在于不同地理层次(邻里、区域和全球)的社会网络不仅是理解这些跨境流动出现的有力分析工具,也是在老挝这样的威权政治环境下为其提供正当性的工具。

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