Walpole Sarah C
Honorary Lecturer, Hull York Medical School, University of York, Heslington, United Kingdom.
Healthc Policy. 2019 Nov;15(2):56-71. doi: 10.12927/hcpol.2019.26071.
The UK's publicly provided National Health Service (NHS) is primarily publicly funded but treats some private-pay patients (PPPs). Little is known about impacts of treating PPPs within publicly provided health systems. This study explores NHS health professionals' experiences and understanding of this phenomenon.
Semi-structured interviews were carried out with NHS clinicians. The interview transcripts were then thematically analyzed.
A total of 17 clinicians highlighted potential impacts in five areas: (1) availability of resources for non-urgent, publicly funded patients, (2) patient safety for publicly funded patients and PPPs, (3) health professional training, (4) NHS finances, and (5) NHS direction setting and values.
In a publicly provided health service that is increasingly treating PPPs, clinicians had limited knowledge of policies for PPP care. Clinicians were concerned about patient safety impacts of prioritizing PPPs over publicly funded patients. Potential cross-subsidies from public to private funding were mooted. The issues raised here require further exploration and may inform research and policy development in the UK and other countries.
英国公共提供的国民医疗服务体系（NHS）主要由公共资金资助，但也治疗一些自费患者（PPPs）。对于在公共提供的卫生系统中治疗自费患者的影响，人们了解甚少。本研究探讨了NHS医疗专业人员对这一现象的经历和理解。
对NHS临床医生进行了半结构化访谈。然后对访谈记录进行了主题分析。
共有17名临床医生强调了五个方面的潜在影响：（1）非紧急公共资助患者的资源可用性，（2）公共资助患者和自费患者的患者安全，（3）医疗专业人员培训，（4）NHS财务，以及（5）NHS的方向设定和价值观。
在一个越来越多地治疗自费患者的公共卫生服务体系中，临床医生对自费患者护理政策的了解有限。临床医生担心将自费患者置于公共资助患者之上对患者安全产生的影响。有人提出了从公共资金到私人资金的潜在交叉补贴问题。这里提出的问题需要进一步探讨，可能会为英国和其他国家的研究和政策制定提供参考。
