Sociology Department, Uppsala University, Uppsala, Sweden.
Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.
Sociol Health Illn. 2020 May;42(4):739-757. doi: 10.1111/1467-9566.13061. Epub 2020 Feb 4.
How people in community settings describe their experience of disappointing health care, and their responses to such dissatisfaction, sheds light on the role of marginalisation and underlines the need for radically responsive service provision. Making the case for studying unprompted accounts of dissatisfaction with healthcare provision, this is an original analysis of 71 semi-structured interviews with healthcare users in superdiverse neighbourhoods in four European cities. Healthcare users spontaneously express disappointment with services that dismiss their concerns and fail to attend to their priorities. Analysing characteristics of these healthcare users show that no single aspect of marginalisation shapes the expression of disappointment. In response to disappointing health care, users sought out alternative services and to persuade reluctant service providers, and they withdrew from services, in order to access more suitable health care and to achieve personal vindication. Promoting normative quality standards for diverse and diversifying populations that access care from a range of public and private service providers is in tension with prioritising services that are responsive to individual priorities. Without an effort towards radically responsive service provision, the ideal of universal access on the basis of need gives way to normative service provision.
人们在社区环境中描述他们对令人失望的医疗保健的体验，以及他们对这种不满的反应，这揭示了边缘化的作用，并强调了提供激进响应式服务的必要性。本文通过对来自四个欧洲城市的超级多样化社区的 71 名医疗保健用户进行的 71 次半结构化访谈的原始分析，为研究未经提示的对医疗保健提供不满的情况提供了依据。医疗保健用户自发地对那些忽视他们的担忧并未能关注他们的首要事项的服务表示失望。对这些医疗保健用户的特征进行分析表明，没有任何一个边缘化方面会影响失望情绪的表达。为了应对令人失望的医疗保健，用户会寻求替代服务并试图说服不情愿的服务提供者，还会退出服务，以获得更合适的医疗保健并实现个人的正名。为了促进多元化和多样化人群的规范质量标准，这些人群可以从一系列公共和私人服务提供者那里获得医疗保健，这与优先考虑响应个人优先事项的服务存在冲突。如果不努力提供激进响应式服务，那么基于需求的普遍获得的理想就会让位于规范服务的提供。
