Justice in health care decision-making: patients' appraisals of health care providers and health plan representatives.
Justice in health care decision-making: patients' appraisals of health care providers and health plan representatives.
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DOI：
10.1007/s11211-005-3393-3
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发表时间：
2005-03-01
影响因子：
2.3
通讯作者：
Moos, Rudolf
中科院分区：
文献类型：
--
作者：
Fondacaro, Mark;Frogner, Bianca;Moos, Rudolf
本研究描述了两个版本的卫生保健公平量表(HCJI)的编制。一个版本侧重于患者与其提供者的互动(HCJI-P)，另一个侧重于患者与其健康计划代表的互动(HCJI-HP)。每个版本的HCJI评估患者对他们互动的评价(与他们的提供者或他们的健康计划的代表)，以及程序正义的三个共同维度：信任、公正性和参与。提供者和健康计划量表都评估相对独立于患者人口统计特征的指数。此外，患者对其与其提供者的互动的评价仅与他们对他们与其健康计划代表的互动的评价适度相关，这表明提供者和健康计划量表利用了患者对医疗保健系统的总体体验的不同方面。总体而言，在提供者和健康计划背景下，程序正义维度都与患者满意度显著相关。正如预测的那样，在提供者中，程序正义因素与患者满意度的联系比在健康计划背景下更强烈，而基于需求的分配正义原则(而不是公平或平等)的卫生保健决策在这两种背景下与患者满意度的联系最密切。
This study describes the development of two versions of a Health Care Justice Inventory (HCJI). One version focuses on patients' interactions with their providers (HCJI-P) and the other focuses on patients' interactions with the representatives of their health plans (HCJI-HP). Each version of the HCJI assesses patients' appraisals of their interactions (with either their Provider or representatives of their Health Plan) along three common dimensions of procedural justice: Trust, Impartiality, and Participation. Both the Provider and Health Plan scales assess indices that are relatively independent of patients' demographic characteristics. In addition, patients' appraisals of their interactions with their provider were only moderately related to their appraisals of their interactions with representatives of their health plan, indicating that the Provider and Health Plan scales tap distinct aspects of patients' overall experience with the health care system. Overall, procedural justice dimensions were significantly related to patient satisfaction in both the Provider and the Health Plan contexts. As predicted, procedural justice factors were more strongly tied to patient satisfaction in the provider than in the Health Plan context, and health care decisions based on distributive justice principles of Need (rather than Equity or Equality) were most closely tied to patient satisfaction in both contexts.