如何公平分配稀缺的医疗资源?具有不同个人特征的医疗保健专业人员有争议的偏好。

IF 3 3区 医学 Q2 HEALTH POLICY & SERVICES
Health Economics Policy and Law Pub Date : 2022-10-01 Epub Date: 2021-06-10 DOI:10.1017/S1744133121000190
Micaela Pinho, Alexandra Araújo
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引用次数: 1

摘要

医疗资源的稀缺性是公认的,因此确定优先事项是不可避免的。本研究考察了葡萄牙医疗保健专业人员(医生与护士)是否:(i)分享伦理学家提出的道德指导,(ii)对优先级标准的态度因个人和专业特征而异。254名医疗保健专业人员的样本面临假设的优先场景,涉及两个患者的个人或健康特征区分。采用描述性统计和参数分析来评估和比较两组医疗保健专业人员在10项配给标准方面的依从性:等待时间、以预期寿命和生活质量衡量的治疗预后、以疼痛和直接死亡风险衡量的健康状况严重程度、以年轻人多于老年人和年轻人多于年轻人衡量的年龄歧视、积极或消极评价的优点、以及父母身份。调查结果显示,这些标准得到了轻微的遵守。与伦理学家的规范相比,受访者认为等待时间和患者疼痛是更公平的条件。对分配公正的偏好因专业群体和具有不同政治取向、配给经验、经验年限和对NHS满意度的参与者而异。决策者应该考虑伦理学家的意见,但也要考虑医疗保健专业人员的意见,以使明确的指导方针合法化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How to fairly allocate scarce medical resources? Controversial preferences of healthcare professionals with different personal characteristics.

The scarcity of medical resources is widely recognized, and therefore priority setting is inevitable. This study examines whether Portuguese healthcare professionals (physicians vs nurses): (i) share the moral guidance proposed by ethicists and (ii) attitudes toward prioritization criteria vary among individual and professional characteristics. A sample of 254 healthcare professionals were confronted with hypothetical prioritization scenarios involving two patients distinguished by personal or health characteristics. Descriptive statistics and parametric analyses were performed to evaluate and compare the adherence of both groups of healthcare professionals regarding 10 rationing criteria: waiting time, treatment prognosis measured in life expectancy and quality of life, severity of health conditions measured in pain and immediate risk of dying, age discrimination measured in favoring the young over older and favoring the youngest over the young, merit evaluated positively or negatively, and parenthood. The findings show a slight adherence to the criteria. Waiting time and patient pain were the conditions considered fairer by respondents in contrast with the ethicists normative. Preferences for distributive justice vary by professional group and among participants with different political orientations, rationing experience, years of experience, and level of satisfaction with the NHS. Decision-makers should consider the opinion of ethicists, but also those of healthcare professionals to legitimize explicit guidelines.

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来源期刊
Health Economics Policy and Law
Health Economics Policy and Law HEALTH POLICY & SERVICES-
CiteScore
5.30
自引率
0.00%
发文量
55
期刊介绍: International trends highlight the confluence of economics, politics and legal considerations in the health policy process. Health Economics, Policy and Law serves as a forum for scholarship on health policy issues from these perspectives, and is of use to academics, policy makers and health care managers and professionals. HEPL is international in scope, publishes both theoretical and applied work, and contains articles on all aspects of health policy. Considerable emphasis is placed on rigorous conceptual development and analysis, and on the presentation of empirical evidence that is relevant to the policy process.
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