Cabieses Báltica, Obach Alexandra, Campaña Carla, Vezzani Francisca, Rodríguez Cecilia, Espinoza Manuel
Programa de Estudios Sociales en Salud, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Department of Health Sciences, University of York, York, England, UK.
Programa de Estudios Sociales en Salud, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Value Health Reg Issues. 2023 Jan;33:42-48. doi: 10.1016/j.vhri.2022.08.011. Epub 2022 Oct 10.
This study aimed to characterize 5 approaches that have been developed in research on patients and health coverage, which reveal information from the perspective of patients: (1) access to healthcare, (2) therapeutic trajectories, (3) social participation in decision making on health coverage, (4) tacit knowledge, and (5) communities of practice.
This is a narrative literature review, based on searches performed in PubMed/MEDLINE and Web of Science, between August and December 2021. A total of 45 scientific articles were selected for analysis, which were complemented by a gray literature search that provided 6 additional manuscripts.
Improving access to health services requires an understanding of the meaning of the concept of access from the users themselves. The patient trajectory approach contributes by emphasizing that the focus of analysis must adopt the patient's perspective, given that it provides valuable information for the decision making on health coverage. In addition, the role that social participation has in the process to grant trust and legitimacy is described. Tacit knowledge makes explicit the importance of revealing it as a source of information that adds value to the decision-making process. Finally, communities of practice are described as spaces where new ways of experiencing the disease originate, as well as ways of relating to the health system and its actors.
The article raises the relevance that various social actors know these approaches, as well as strategies to integrate them into the assessment processes in terms of health coverage.
本研究旨在描述在患者与医保研究中已开发出的5种方法，这些方法从患者角度揭示信息：（1）医疗服务可及性；（2）治疗轨迹；（3）医保决策中的社会参与；（4）隐性知识；（5）实践社群。
这是一项叙述性文献综述，基于2021年8月至12月在PubMed/MEDLINE和科学网进行的检索。共选择45篇科学文章进行分析，并通过灰色文献检索补充了另外6篇手稿。
改善医疗服务可及性需要从用户自身理解可及性概念的含义。患者轨迹方法强调分析重点必须采用患者视角，因为它为医保决策提供有价值信息，从而做出贡献。此外，还描述了社会参与在赋予信任和合法性过程中的作用。隐性知识明确了将其作为为决策过程增添价值的信息来源加以揭示的重要性。最后，实践社群被描述为产生疾病新体验方式以及与卫生系统及其参与者建立联系方式的空间。
本文提出各类社会行为者了解这些方法的相关性，以及将它们整合到医保评估过程中的策略。
