Health care priorities: the community's preferences for using community preferences

决定应该如何分配卫生保健资源--通常被称为配给或优先设置--传统上是由卫生保健人员执行的，通常是医生，但越来越多的是管理人员。最近，有一项让普通公众参与这一进程的举措。这一领域的大部分研究都集中在用来引起社区偏好的方法上。虽然这是一个重要的调查领域，但需要调查的是社区成员对使用他们的偏好来告知卫生保健优先事项的看法。这项研究将解决四个具体问题：(I)普通公众是否认为，作为个人，他们在为卫生保健的优先决定提供信息方面有合法的作用？如果是这样，为什么？若否，原因为何？(2)确定优先事项的决定的性质是否会影响个别公众是否愿意参与确定优先事项的过程？(例如，不同的保健服务、医疗程序--治疗、疾病)(Iii)如果不是社区的偏好，应该使用谁的偏好？(4)事后面对社区的偏好和保健服务决策者(即OExpert‘s)的偏好(可能不同)，这种知识是否会影响让社区偏好计入的偏好？一些卫生当局目前正在寻找让当地社区参与卫生保健决策的方法。这项研究将指出在什么程度上要引起社区偏好，以及它们最相关的决策和环境的类型。

Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use of their preferences in informing health care priorities needs to be investigated. Four specific questions will be addressed in this study: (i) do members of the general public feel that, as individuals, they have a legitimate role to play in informing priority decisions in health care? if so why? if not, why not? (ii) does the nature-level-setting of the decisions for which priorities are to be set affect whether individual members of the public would wish to participate in the priority setting process? (e.g. different health services, medical procedures-treatments, diseases) (iii) whose preferences should be used if not the community's? (iv) faced ex post with the preferences of the community and the preferences (possibly different) of health service decision makers (i.e. Oexperts'), does this knowledge affect preferences for having community preferences count? A number of health authorities are currently looking for ways of engaging local communities in health care decision making. This study will indicate the appropriate levels at which community preferences are to be elicited and the type of decisions and settings in which they are most relevant.