Thacker S B, Osborne C, Salber E J
J Community Health. 1978 Summer;3(4):347-56. doi: 10.1007/BF01498509.
We combine two standard approaches to analyze power and influence in health policy formulation within a moderately large county in the south. Intrinsic methodologic weaknesses are discussed and several conclusions are drawn regarding power in the health care sector of that community. The most significant finding is the shift in power over time, away from the individuals to committees and health care organizations. The ignorance of most physicians about the broader health care issues that affect the community was reflected in their lack of recognition by others in the community as influential decision makers. The insular relationship of the university to the rest of the community was also noted. Past racial politics had a continuing effect on later health policy formulation. These findings are discussed in light of current and past issues. Because we had promised confidentiality to the persons we interviewed, fictitious names were given to the county, the institutions, and the interviewees.
我们结合两种标准方法，对美国南部一个中等规模的县卫生政策制定中的权力和影响力进行分析。文中讨论了内在的方法学弱点，并就该社区医疗保健部门的权力得出了几个结论。最显著的发现是，随着时间的推移，权力从个人转移到了委员会和医疗保健组织。大多数医生对影响社区的更广泛医疗保健问题的忽视，体现在社区其他成员未将他们视为有影响力的决策者。还指出了该大学与社区其他部分之间的孤立关系。过去的种族政治对后来的卫生政策制定产生了持续影响。结合当前和过去的问题对这些发现进行了讨论。由于我们已向受访者承诺保密，因此对该县、各机构和受访者均使用了化名。
