Daniels Tom, Williams Iestyn, Bryan Stirling, Mitton Craig, Robinson Suzanne
1Health Services Management Centre,University of Birmingham,Birmingham,UK.
2Faculty of Medicine,University of British Columbia,Vancouver,BC,Canada.
Health Econ Policy Law. 2018 Apr;13(2):162-188. doi: 10.1017/S1744133117000330. Epub 2017 Dec 29.
Public involvement in disinvestment decision making in health care is widely advocated, and in some cases legally mandated. However, attempts to involve the public in other areas of health policy have been accused of tokenism and manipulation. This paper presents research into the views of local health care leaders in the English National Health Service (NHS) with regards to the involvement of citizens and local communities in disinvestment decision making. The research includes a Q study and follow-up interviews with a sample of health care clinicians and managers in senior roles in the English NHS. It finds that whilst initial responses suggest high levels of support for public involvement, further probing of attitudes and experiences shows higher levels of ambivalence and risk aversion and a far more cautious overall stance. This study has implications for the future of disinvestment activities and public involvement in health care systems faced with increased resource constraint. Recommendations are made for future research and practice.
医疗保健领域的撤资决策中公众参与受到广泛倡导，在某些情况下还具有法律规定。然而，让公众参与卫生政策其他领域的尝试却被指责是形式主义和操纵行为。本文介绍了对英国国家医疗服务体系（NHS）中地方医疗保健领导者关于公民和当地社区参与撤资决策的观点的研究。该研究包括一项Q研究以及对英国NHS中担任高级职务的医疗保健临床医生和管理人员样本的后续访谈。研究发现，虽然最初的回应表明对公众参与高度支持，但对态度和经历的进一步探究显示出更高程度的矛盾心理和风险规避，以及总体上更为谨慎的立场。这项研究对撤资活动的未来以及面临资源约束加剧的医疗保健系统中的公众参与具有启示意义。针对未来研究和实践提出了建议。
