Shamir Medical Center, Be'er Yaakov, Israel.
Bar-Ilan University, Ramat Gan, Israel.
Int J Equity Health. 2023 Aug 30;22(1):170. doi: 10.1186/s12939-023-01979-3.
Patient-centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by healthcare professionals, and patients' capability, self-efficacy, and willingness to take part in medical decisions. We aim to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as they bridge between policy strategies and patients. We try to reveal cultural differences by comparing the views of the majority and the minority subpopulations of Israel (Arabic and Hebrew speakers).
A cross-sectional survey among JMM studying for an advanced degree in health-system management at three academic training colleges in Israel was conducted in February-March 2022. The respondents completed a structured questionnaire comprising four sections: a) perceptions of trust, accountability, insurance coverage, and economic status; b) perceptions regarding decision-making mechanisms; c) preferences toward achieving equity, and d) demographic details.
A total of 192 respondents were included in the study-50% Hebrew speakers and 50% Arabic speakers. No differences were found between Arabic and Hebrew speakers regarding perception of trust, accountability, insurance coverage, and economic status. JMM from both subpopulations believed that patients' gender and age do not influence physicians' attitudes but Arabic-speaking respondents perceived that healthcare professionals prefer educated patients or those with supportive families. All respondents believed that patients would like to be more involved in medical decisions; yet Arabic-speakers perceived patients as tending to rely on physicians' recommendations while Hebrew speakers believed that patients wish to lead the medical decision by themselves.
Patient-centeredness strategy needs to be implemented bottom-up as well as top-down, in a transparent nationwide manner. JMM are key actors in carrying out this strategy because they realize policy guidelines in the context of social disparities, enabling them to achieve a friendly personalized dialogue with their patients. We believe that empowering these JMM may create a ripple effect, yielding a bottom-up perception of equity and initiating change.
以患者为中心是医疗保健的核心要素。然而，医疗专业人员对这一术语的理解与患者参与医疗决策的能力、自我效能感和意愿之间存在差距。我们旨在揭示初级医疗管理人员（JMM）对“以患者为中心”的观点，因为他们在政策策略和患者之间架起了桥梁。我们试图通过比较以色列的多数群体和少数群体（阿拉伯语和希伯来语使用者）的观点来揭示文化差异。
2022 年 2 月至 3 月，在以色列三所学术培训学院攻读卫生系统管理高级学位的 JMM 中进行了一项横断面调查。受访者完成了一份包含四个部分的结构化问卷：a）对信任、问责制、保险覆盖范围和经济状况的看法；b）对决策机制的看法；c）对实现公平的偏好；d）人口统计细节。
共有 192 名受访者参与了这项研究，其中 50%是希伯来语使用者，50%是阿拉伯语使用者。阿拉伯语和希伯来语使用者在信任、问责制、保险覆盖范围和经济状况方面没有差异。来自这两个群体的 JMM 都认为患者的性别和年龄不会影响医生的态度，但阿拉伯语受访者认为医疗保健专业人员更喜欢受过教育的患者或有家属支持的患者。所有受访者都认为患者希望更多地参与医疗决策；然而，阿拉伯语使用者认为患者倾向于依赖医生的建议，而希伯来语使用者则认为患者希望自己主导医疗决策。
以患者为中心的策略需要以透明的全国性方式自上而下和自下而上地实施。JMM 是实施这一策略的关键角色，因为他们在社会差异的背景下实现政策指导方针，使他们能够与患者进行友好的个性化对话。我们相信，赋予这些 JMM 权力可能会产生连锁反应，产生对公平的自下而上的看法，并引发变革。
