Ojanuga D N, Lefcowitz M J
Soc Sci Med. 1982;16(18):1649-52. doi: 10.1016/0277-9536(82)90296-9.
Against the background of two highly competitive systems of medicine in Nigeria four types of health care consumers are identified in this paper. Health Consumer I utilizes either the traditional or scientific system exclusively. Health consumer II utilizes the traditional system and when dissatisfied turns to the scientific system: while health consumer III utilizes the scientific system first and later turns to the alternative system. Health consumer IV utilizes both systems simultaneously. Illness behaviour as exhibited by these consumers has negative consequences on the successful delivery of medical services in Nigeria in that scarce resources are wasted through duplication of services and personnel. Furthermore competition between both systems is heightened by the defection of patients to the alternative system. A solution to these problems is offered through the reorganization of the governmental health services to include the traditional sector. It is suggested that an intregrated governmental medical services may result in stabilizing the health consumer and producing an economically more viable system of medicine for the country.
在尼日利亚两种高度竞争的医疗体系背景下,本文确定了四类医疗保健消费者。第一类健康消费者只使用传统或科学体系。第二类健康消费者使用传统体系,不满意时则转向科学体系;而第三类健康消费者首先使用科学体系,之后转向替代体系。第四类健康消费者同时使用两种体系。这些消费者表现出的疾病行为对尼日利亚医疗服务的成功提供产生了负面影响,因为稀缺资源因服务和人员的重复而被浪费。此外,患者转向替代体系加剧了两种体系之间的竞争。通过重组政府卫生服务以纳入传统部门来提供解决这些问题的办法。建议整合的政府医疗服务可能会使健康消费者稳定下来,并为该国产生一个经济上更可行的医疗体系。