Do physicians' attitudes toward prioritization predict poor-health patients' access to care?

IF 2 3区 医学 Q2 ECONOMICS
Health economics Pub Date : 2024-05-14 DOI:10.1002/hec.4843
Anne Sophie Oxholm, Dorte Gyrd-Hansen
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Abstract

Physicians often face tight resource constraints, meaning they have to make trade-offs between which patients they care for and the amount of care received. Studies show that patients requiring many resources disproportionately suffer a loss of care when resources are constrained. This study uncovers whether physicians' attitudes toward prioritization of healthcare predicts poor-health patients' access to care. We combine unique survey data on Danish GPs' preferred prioritization principle with register data on their patients' contacts in general practice. We consider different types of contacts as the required effort could impact the need for prioritization. Our results show variation in GPs' prioritization principles, where a majority prefers a principle that may lead to an unequal distribution of services. We further find that GPs' attitudes toward prioritization predict some poor-health patients' access to general practice. GPs who state they prefer the principle of prioritizing patients in the poorest health state when resources tightened provide more contacts to poor-health patients. The additional contacts are typically high-effort contacts such as annual status meetings and home visits, but also low-effort contacts such as emails. Our findings indicate inequity in poor-health patients' access to care across general practices.

Abstract Image

医生对优先顺序的态度是否预示着健康状况不佳的患者能否获得医疗服务?
医生经常面临资源紧张的问题,这意味着他们必须在护理哪些病人和护理量之间做出权衡。研究表明,当资源紧张时,需要大量资源的病人会不成比例地失去治疗。本研究揭示了医生对医疗保健优先次序的态度是否能预测健康状况不佳的患者能否获得医疗服务。我们将丹麦全科医生首选优先原则的独特调查数据与全科医生接触患者的登记数据相结合。我们考虑了不同类型的接触,因为所需的努力可能会影响对优先顺序的需求。我们的结果显示,全科医生的优先排序原则存在差异,大多数全科医生更倾向于可能导致服务分配不均的原则。我们进一步发现,全科医生对优先原则的态度可以预测一些健康状况不佳的病人能否得到全科医疗服务。那些表示在资源紧张时更倾向于优先照顾健康状况最差的病人的全科医生会为健康状况差的病人提供更多的接触机会。这些额外的接触通常是高强度的接触,如年度状况会议和家访,但也有低强度的接触,如电子邮件。我们的研究结果表明,健康状况不佳的患者在普通诊所获得医疗服务的机会并不公平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
期刊介绍: This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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