Division of Society and Health at the Department of Health, Medicine and Caring Sciences, Swedish National Centre for Priorities in Health, Linköping University, 581 83 Linköping, Sweden.
Health Econ Policy Law. 2024 Jul;19(3):337-352. doi: 10.1017/S1744133124000021. Epub 2024 Mar 7.
The allocation of resources is a crucial part of political decision-making in healthcare, but explicit priorities are rarely set when resources are distributed. Two areas that have received some attention in research about legitimacy and priority-setting decisions in healthcare are the role of technical expert agencies as mediating institutions and the role of elected politicians. This paper investigates a political priority-setting advisory committee within a regional authority in Sweden. The aim is to explore how a political body can serve as a mediating institution for priority-setting in healthcare by disentangling the arrangements of its work in terms of what role it performs in the organisation and what it should do. The findings illustrate that promoting the notion of explicit priority-setting and the political aspects inherent in priority-setting in political healthcare management can contribute to consolidating political governance and leadership. There is, however, a complex tension between stability and conflicting values which has implications for the role of politicians as citizens' democratic representatives. This paper enhances our understanding of the role of mediating institutions and political properties of healthcare priority-setting, as well as our understanding of political and democratic healthcare governance in local self-government.
资源分配是医疗保健政治决策的关键部分，但在分配资源时很少明确设定优先事项。在医疗保健领域的合法性和优先事项设定决策研究中，有两个领域受到了一些关注，即技术专家机构作为调解机构的作用和民选政治家的作用。本文研究了瑞典一个地区当局内的政治优先事项设定咨询委员会。目的是通过厘清其工作安排，探讨政治机构如何通过在组织中发挥的作用以及应该做什么来充当医疗保健优先事项设定的调解机构。研究结果表明，在政治医疗保健管理中推广明确的优先事项设定概念以及优先事项设定所固有的政治方面，可以有助于巩固政治治理和领导地位。然而，在稳定和相互冲突的价值观之间存在着复杂的紧张关系，这对政治家作为公民民主代表的角色产生了影响。本文增进了我们对调解机构的作用和医疗保健优先事项设定的政治属性的理解，以及对地方自治中政治和民主医疗保健治理的理解。
