Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology
Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology
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DOI：
10.1016/j.socscimed.2014.12.023
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发表时间：
2015-02-01
影响因子：
5.4
通讯作者：
Brouwer, Werner
中科院分区：
文献类型：
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作者：
van Exel, Job;Baker, Rachel;Brouwer, Werner
卫生保健部门可用的资源有限，通常不足以满足人口对卫生保健的所有需求。必须就提供哪些治疗做出决定。公众对指导这种决策的原则的看法相对较少。我们展示了Q方法研究的结果，该研究旨在引起十个国家的公众对卫生保健资源优先排序的适当原则的共同看法。2010年，294名受访者对一套卡片进行了排序，并对这些卡片的结果进行了逐人因素分析，以确定排序的常见模式。与会者提出了五种不同的观点：(I)“平均主义、应得权利和获得机会的平等”；(Ii)“健康收益的严重性和大小”；(Iii)“公平计分、年轻人和最大限度地提高健康福利”；(Iv)“生命和健康生活的内在价值”；(V)“生活质量比简单地活着更重要”。因此，决策过程变得更加重要，可以说，社会上的这些多元视角应该以某种方式反映出来。(C)2014爱思唯尔有限公司。保留所有权利。
Resources available to the health care sector are finite and typically insufficient to fulfil all the demands for health care in the population. Decisions must be made about which treatments to provide. Relatively little is known about the views of the general public regarding the principles that should guide such decisions.We present the findings of a Q methodology study designed to elicit the shared views in the general public across ten countries regarding the appropriate principles for prioritising health care resources. In 2010, 294 respondents rank ordered a set of cards and the results of these were subject to by-person factor analysis to identify common patterns in sorting. Five distinct viewpoints were identified, (I) "Egalitarianism, entitlement and equality of access"; (II) "Severity and the magnitude of health gains"; (III) "Fair innings, young people and maximising health benefits"; (IV) "The intrinsic value of life and healthy living"; (V) "Quality of life is more important than simply staying alive".Given the plurality of views on the principles for health care priority setting, no single equity principle can be used to underpin health care priority setting. Hence, the process of decision making becomes more important, in which, arguably, these multiple perspectives in society should be somehow reflected. (C) 2014 Elsevier Ltd. All rights reserved.