'The public is too subjective': public involvement at different levels of health-care decision making
'The public is too subjective': public involvement at different levels of health-care decision making
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DOI：
10.1016/s0277-9536(01)00151-4
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发表时间：
2002-06-01
影响因子：
5.4
通讯作者：
Morgan, K
中科院分区：
文献类型：
--
作者：
Litva, A;Coast, J;Morgan, K
公众参与卫生保健决策有许多冲动，包括工具主义、社群主义、教育和表达冲动以及增加问责制的愿望。但是，有。很少有研究系统地研究公众对参与特定类型配给决策的偏好，事实上也是如此。是否对公众所期望的参与程度进行了严格的审查。这里报告的研究使用焦点小组和深入访谈的结果来探讨这些问题。进行了八个焦点小组，共57个线人，其中四个随机选择的公众成员和四个线人前线卫生和非卫生相关组织，进行了19次访谈，允许，焦点小组的意见阐述。更深入地探讨各种观点，并探讨新出现的主题。调查结果显示，公众参与医疗保健决策的意愿存在差异，不同形式的公众之间存在一致性，这些公众由随机选择的公民和预先存在的组织组成的焦点小组代表。所有团体都强烈希望公众参与系统和方案两级的工作。他们不太愿意参与到个人层面上。在系统和方案一级，提供信息者一般赞成协商，而不负责作出决定。但要保证听取他们的意见，并对协商后作出的决定作出解释。在病人一级，被调查者认为，公众只应通过制定标准来参与决定治疗的潜在受益者。公众可以作出很大贡献，特别是在系统和方案一级。以补充卫生保健专业人员的投入。(C)2002爱思唯尔科技有限公司。保留所有权利。
There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however. been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed. has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants front health and non-health related organisations, Nineteen interviews were conducted to allow, the elaboration of focus group comments. to probe views more deeply and to pursue emerging themes. The findings show, variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels. with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions. but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels. to supplement the inputs of health care professionals. (C) 2002 Elsevier Science Ltd. All rights reserved.