کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
955192 927711 2005 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Priority setting in hospitals: Fairness, inclusiveness, and the problem of institutional power differences
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
پیش نمایش صفحه اول مقاله
Priority setting in hospitals: Fairness, inclusiveness, and the problem of institutional power differences
چکیده انگلیسی

Priority setting tends to take place in health care settings that are hierarchical and politically complex. Fair processes, as defined for example by Daniels’ and Sabin's accountability for reasonableness framework, have been identified as essential for securing socially acceptable priority setting decisions. However, power differences in the decision-making context can pose a serious impediment to fair priority setting in health care organizations. Comparatively little attention has been paid to examining the institutional conditions within which priority setting decisions are made. We review a case study of priority setting in hospital operational planning in Toronto, which had been designed by executive leaders to be broadly inclusive of senior and middle-level clinical and administrative leaders. We report three power differences that arose as limiting factors on the inclusiveness of the priority setting process. We argue that these findings have significant theoretical implications for the accountability for reasonableness framework and propose a fifth condition, the “empowerment condition”, which states that there should be efforts to minimise power differences in the decision-making context and to optimise effective opportunities for participation in priority setting.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 61, Issue 11, December 2005, Pages 2355–2362
نویسندگان
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