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医疗服务提供者的选择:喀麦隆西北省

Health care provider choice: the North West Province of Cameroon.

作者信息

Tembon A C

机构信息

Save the Children Fund (UK), Khartoum, Sudan.

出版信息

Int J Health Plann Manage. 1996 Jan-Mar;11(1):53-67. doi: 10.1002/(SICI)1099-1751(199601)11:1<53::AID-HPM413>3.0.CO;2-A.

Abstract

Health care is provided in many developing countries free of any charge at the point of delivery. This is attributed to the fact that health care is one of the basic human rights. While modern health care in public health units is free, patients in rural areas continue to use either self-care, traditional healers or both. In Cameroon, the idea of integrating traditional and modern medical practices is discussed by both traditional and medical practitioners. However, it is not very clear what influences the household's choice of one or the other. Within a health district, where there are many providers, the question as to whether or not there is a possibility of choice open to all is posed. This article reports on a study undertaken in a rural health district that shows that there are many factors that influence the choice of health care. Among these factors is quality of care which is the most important factor influencing the choice of health care provider. As quality of care increases in governmental health centres, their choice probability also increases. Other factors include: the time spent seeking treatment; household income and size; distance; and, cost of health care. Those with higher incomes tend to choose private health units and those with larger families tend to choose government health units. Other socio-cultural factors, difficult to model, appear to also influence the choice of providers. It is concluded that since household income influences the choice of private health units, policies targeting poverty alleviation should be instituted in the rural areas to provide households with income. This will enable them widened access to private health care and enable government to redeploy its scarce resources to maintain and extend services to needy areas.

摘要

在许多发展中国家,医疗保健在提供时是免费的。这归因于医疗保健是基本人权之一这一事实。虽然公共卫生单位的现代医疗保健是免费的,但农村地区的患者仍继续采用自我护理、传统治疗师或两者兼用的方式。在喀麦隆,传统治疗师和医疗从业者都在讨论整合传统和现代医疗实践的想法。然而,目前尚不清楚是什么影响了家庭对其中一种或另一种方式的选择。在一个有许多医疗服务提供者的健康区,就提出了是否对所有人都存在选择可能性的问题。本文报道了在一个农村健康区进行的一项研究,该研究表明有许多因素会影响医疗保健的选择。其中,护理质量是影响医疗服务提供者选择的最重要因素。随着政府医疗中心护理质量的提高,其被选择的概率也会增加。其他因素包括:寻求治疗所花费的时间;家庭收入和规模;距离;以及医疗保健费用。收入较高的人倾向于选择私立医疗单位,而家庭规模较大的人倾向于选择政府医疗单位。其他难以建模的社会文化因素似乎也会影响医疗服务提供者的选择。得出的结论是,由于家庭收入会影响对私立医疗单位的选择,因此应在农村地区制定旨在扶贫的政策,为家庭提供收入。这将使他们能够更广泛地获得私立医疗保健服务,并使政府能够重新调配其稀缺资源,以维持并将服务扩展到贫困地区。

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