Harris Claire, Ko Henry, Waller Cara, Sloss Pamela, Williams Pamela
School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia.
Centre for Clinical Effectiveness, Monash Health, Clayton, VIC, Australia.
BMC Health Serv Res. 2017 May 5;17(1):329. doi: 10.1186/s12913-017-2212-5.
This is the fourth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Healthcare decision-makers have sought to improve the effectiveness and efficiency of services through removal or restriction of practices that are unsafe or of little benefit, often referred to as 'disinvestment'. A systematic, integrated, evidence-based program for disinvestment was being established within a large Australian health service network. Consumer engagement was acknowledged as integral to this process. This paper reports the process of developing a model to integrate consumer views and preferences into an organisation-wide approach to resource allocation.
A literature search was conducted and interviews and workshops were undertaken with health service consumers and staff. Findings were drafted into a model for consumer engagement in resource allocation which was workshopped and refined.
Although consumer engagement is increasingly becoming a requirement of publicly-funded health services and documented in standards and policies, participation in organisational decision-making is not widespread. Several consistent messages for consumer engagement in this context emerged from the literature and consumer responses. Opportunities, settings and activities for consumer engagement through communication, consultation and participation were identified within the resource allocation process. Sources of information regarding consumer values and perspectives in publications and locally-collected data, and methods to use them in health service decision-making, were identified. A model bringing these elements together was developed.
The proposed model presents potential opportunities and activities for consumer engagement in the context of resource allocation.
本文是系列论文中的第四篇，报道了在当地医疗环境中通过有效分配资源实现医疗保健可持续性（SHARE）的项目。医疗保健决策者试图通过消除或限制不安全或益处不大的做法（通常称为“撤资”）来提高服务的有效性和效率。澳大利亚一个大型医疗服务网络正在建立一个系统、综合、基于证据的撤资项目。消费者参与被认为是这一过程不可或缺的一部分。本文报告了开发一个模型的过程，该模型将消费者的观点和偏好纳入全组织范围的资源分配方法中。
进行了文献检索，并与医疗服务消费者和工作人员进行了访谈和举办了研讨会。研究结果被起草成一个消费者参与资源分配的模型，并进行了研讨和完善。
尽管消费者参与越来越成为公共资助医疗服务的一项要求，并在标准和政策中有记录，但参与组织决策并不普遍。文献和消费者的回应中出现了一些在这种情况下消费者参与的一致信息。在资源分配过程中确定了通过沟通、协商和参与进行消费者参与的机会、环境和活动。确定了出版物和本地收集数据中有关消费者价值观和观点的信息来源，以及在医疗服务决策中使用这些信息的方法。开发了一个将这些要素整合在一起的模型。
所提出的模型为消费者在资源分配背景下的参与提供了潜在的机会和活动。
