Schröder Sara Lena, Martin Olaf, Mlinarić Martin, Richter Matthias
Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale).
Gesundheitswesen. 2019 Jul;81(7):564-569. doi: 10.1055/s-0043-122231. Epub 2017 Dec 7.
The aim of this qualitative study was to explore inequalities in healthcare from the patient's perspective.
44 semi-structured interviews with patients, aged 59-80 years, were conducted at the university hospital in Halle, Germany in 2014 and 2015. We analyzed the narratives following inductive qualitative content analysis.
Most of the patients (82%) perceived inequalities in healthcare. Dimensions of healthcare inequalities from the patient's perspective were regional differences, type of health insurance, quality of physicians and the patients themselves (Income, Age). The patient's engagement in utilization was mentioned most often as a dimension of inequalities, but not considered a disadvantage. From the patient's perspective, inequalities were more prevalent in the outpatient sector (waiting time, lack of time). Economization in the healthcare system was viewed as the main reason of healthcare inequalities. We found no differences between patients of high and low socioeconomic status.
From the patient´s point of view, their own capacity to orient and engage themselves in the healthcare system, as well as reduction of barriers to accessing outpatient care are highly important for reducing inequalities in healthcare.
本定性研究旨在从患者角度探讨医疗保健中的不平等现象。
2014年和2015年在德国哈雷的大学医院对44名年龄在59至80岁之间的患者进行了半结构化访谈。我们采用归纳定性内容分析法对访谈内容进行了分析。
大多数患者（82%）察觉到了医疗保健中的不平等现象。从患者角度来看，医疗保健不平等的维度包括地区差异、医疗保险类型、医生质量以及患者自身因素（收入、年龄）。患者在医疗利用方面的参与度最常被提及为不平等的一个维度，但并不被视为一种劣势。从患者角度来看，不平等现象在门诊部门更为普遍（等待时间、时间不足）。医疗保健系统的经济化被视为医疗保健不平等的主要原因。我们发现社会经济地位高和低的患者之间没有差异。
从患者的角度来看，他们自身在医疗保健系统中的导向和参与能力，以及减少门诊医疗的障碍对于减少医疗保健不平等至关重要。
