Riska E, Taylor J A
J Health Polit Policy Law. 1978 Spring;3(1):112-23. doi: 10.1215/03616878-3-1-112.
Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.
地方卫生政策制定者和医学社会学家都忽视了消费者对影响当地社区卫生政策决策的关键问题的态度。作者报告了一项实证分析，内容包括：（1）消费者对联邦政府干预医疗保健的态度；（2）消费者对医疗服务提供者自由市场理念的看法；（3）消费者对自身参与卫生政策制定的看法；（4）消费者对当前卫生服务提供系统的信心；（5）消费者对近期主要卫生立法的认知。研究发现，消费者对近期的医疗保健立法了解甚少。作者将消费者的态度与当地医院董事会成员对卫生政策问题的态度进行了比较。所有比较的差异均具有统计学意义。作者认为，医院董事会成员将卫生服务提供中的问题归因于需求功能失调，而消费者则认为这些问题是供应功能失调的结果。因此，在卫生政策委员会中不纳入消费者，必然无法进行以解决问题为导向的对话，并促使以提供者为偏向的意识形态持续占据主导地位。
