Knowledge matters: producing and using knowledge to navigate healthcare systems
Knowledge matters: producing and using knowledge to navigate healthcare systems
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知识很重要：产生和使用知识来驾驭医疗保健系统
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
M. Calnan
中科院分区：
文献类型：
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作者：
K. Willis;F. Collyer;Sophie A. Lewis;J. Gabe;I. Flaherty;M. Calnan
摘要在许多现代医疗系统中，人们希望个人成为理性的参与者--权衡现有的知识，并就自己的医疗需求做出选择。在政策背景下，这最明确地适用于鼓励购买私人健康保险的医疗保健融资。然而，人们对公共和私人医疗保健提供的看法、对医疗保健需求的了解以及人们选择的服务类型，远远不是直截了当的。借鉴布迪厄的习性、领域和资本的概念，以及对澳大利亚医疗保健个人选择经验的研究，我们探索了人们在医疗保健系统中导航时所使用的知识。这种导航发生在权威医学知识与其他来源的知识交叉的环境中，包括互联网和生活经验。然而，我们的研究表明，医疗服务的导航最重要的是能够利用“系统知识”。系统知识有两种形式，有时是重叠的。首先，所获得的系统知识是通过利用经验、正式知识和进行研究的能力(主要是文化资本)来产生的。其次，假定的系统知识能够通过访问和利用特权网络(主要是经济和社会资本)来导航医疗体系。
ABSTRACT In many contemporary healthcare systems, individuals are expected to be rational actors – weighing up available knowledge and making choices about their healthcare needs. In the policy context, this has been most explicitly applied to the financing of healthcare where there is encouragement for the purchase of private health insurance. However, perceptions of public and private healthcare provision, knowledge about healthcare needs, and the types of services people choose, are far from straightforward. Drawing on Bourdieu’s concepts of habitus, field, and capital, and a study of individual experiences of choice in Australian healthcare, we explore the knowledges used by people as they navigate through the healthcare system. Such navigation takes place in a milieu where authoritative medical knowledge intersects with knowledge from other sources, including the Internet and lived experience. However, our study reveals that navigation of healthcare is assisted most of all by the capacity to draw on ‘system knowledge’. System knowledge takes two, sometimes overlapping, forms. First, acquired system knowledge is produced through drawing on experience, formal knowledge and the capacity to undertake research (primarily cultural capital). Second, assumed system knowledge enables navigation of the healthcare system through accessing and utilising networks of privilege (primarily economic and social capital).