选择性精神健康护理中治疗名额的分配--候诊名单是伦理上最合适的选择吗?

Thomas Haustein,Ralf J Jox
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引用次数: 0

摘要

候诊名单是管理择期医疗需求过剩的一种标准方法。虽然候诊时间是一个重要的政策问题,但先来后到(FCFS)原则在伦理上的有效性却很少受到质疑。我们以一家精神科日间医院为例,在这家医院里,所有符合条件的病人都有大致相同的要求,我们批评了在分配精神科择期医疗时条件反射地使用 "先到先得 "原则的做法,考虑了在什么情况下这可能不是最佳策略,并讨论了替代方案。我们的结论是,在我们的例子中,优先考虑更近期的转介(后到先得 [LCFS])在临床和伦理上都更合理。在 "后进先出 "原则下,如果有几个转诊病人(几乎)同时到达,我们建议采用更高水平的审查,以发现优先处理其中一个病人的可能理由。我们相信,我们的观察结果可以应用到与我们的案例具有相同特点的其他医疗环境中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Allocation of Treatment Slots in Elective Mental Health Care-Are Waiting Lists the Ethically Most Appropriate Option?
Waiting lists are a standard approach to managing excess demand in elective health care. While waiting times are an important policy issue, the ethical validity of the first come, first served (FCFS) principle as such is rarely questioned. Presenting a psychiatric day hospital where all eligible patients have roughly equal claims as a case study, we criticize the reflex use of FCFS for allocation of elective psychiatric care, consider conditions under which this may not be the optimal strategy, and discuss alternatives. We conclude that in our example prioritizing more recent referrals (last come, first served [LCFS]) makes more sense, clinically and ethically. Where several referrals arrive (near-)simultaneously under LCFS, we propose that a higher level of scrutiny be applied to detect possible good reasons for prioritizing one of them. We believe that our observations can be applied to other health care settings that share relevant characteristics with our case.
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