Department of Management Control and Information Systems, School of Economics and Business, Universidad de Chile, Diagonal Paraguay 257, Office 2004, Santiago, Chile.
College of Public Health and Human Sciences, Oregon State University, 013 Milam Hall, Corvallis, OR, USA.
BMC Public Health. 2021 Feb 27;21(1):416. doi: 10.1186/s12889-021-10455-y.
This study aims to assess preferences and values for priority setting in healthcare in Chile through an original and innovative survey method. Based on the answers from a previous survey that look into the barriers the Chilean population face, this study considers the preferences of the communities overcoming those barriers. As a result six programs were identified: (1) new infrastructure, (2) better healthcare coverage, (3) increasing physicians/specialists, (4) new informatics systems, (5) new awareness healthcare programs, and (6) improving availability of drugs.
We applied an innovative survey method developed for this study to sample subjects to prioritize these programs by their opinion and by allocating resources. The survey also asked people's preferences for a distributive justice principle for healthcare to guide priority setting of services in Chile. The survey was conducted with a sample of 1142 individuals.
More than half of the interviewees (56.4%) indicated a single program as their first priority, while 20.1% selected two of them as their first priority. To increase the number of doctors/specialists and improve patient-doctor communication was the program that obtained the highest priority. The second and third priorities correspond to improving and investing in infrastructure and expanding the coverage of healthcare insurances. Additionally, the results showed that equal access for equal healthcare is the principle selected by the majority to guide distributive justice for the Chilean health system.
This study shows how a large population sample can participate in major decision making of national health policies, including making a choice of a distributive justice principle. Despite the complexity of the questions asked, this study demonstrated that with an innovative method and adequate guidance, average population is capable of engaging in expressing their preferences and values. Results of this study provide policy-makers useful community generated information for prioritizing policies to improve healthcare access.
本研究旨在通过一种新颖且创新的调查方法，评估智利医疗保健中优先事项设定的偏好和价值观。基于此前一项调查中对智利民众面临的障碍的研究，本研究考虑了克服这些障碍的社区的偏好。结果确定了六个项目：（1）新基础设施，（2）更好的医疗保健覆盖范围，（3）增加医生/专家，（4）新的信息系统，（5）新的卫生保健宣传计划，以及（6）改善药品供应。
我们应用了一种为这项研究开发的创新调查方法，通过受访者的意见和资源分配来对这些项目进行优先排序。该调查还询问了人们对医疗保健分配正义原则的偏好，以指导智利服务的优先事项设定。该调查是在 1142 名个体的样本中进行的。
超过一半的受访者（56.4%）表示单一项目是他们的第一优先事项，而 20.1%的受访者选择其中两个作为他们的第一优先事项。增加医生/专家的数量并改善医患沟通是获得最高优先级的项目。第二和第三优先事项对应于改善和投资基础设施以及扩大医疗保险的覆盖范围。此外，结果表明，平等获得平等医疗保健是大多数人选择指导智利卫生系统分配正义的原则。
本研究表明，大量的人口样本可以参与国家卫生政策的重大决策，包括选择分配正义原则。尽管提出的问题很复杂，但本研究表明，通过创新方法和充分的指导，普通民众有能力表达他们的偏好和价值观。这项研究的结果为决策者提供了有用的社区生成信息，以优先考虑改善医疗保健机会的政策。
