个人需求与国家需求：公众对个人和国家层面医疗保健优先事项的态度。
Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.
作者信息
Kaplan Giora, Baron-Epel Orna
机构信息
The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621 Israel.
School of Public Health, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
出版信息
Isr J Health Policy Res. 2015 May 15;4:15. doi: 10.1186/s13584-015-0010-2. eCollection 2015.
BACKGROUND
Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level.
METHODS
A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance.
RESULTS
Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance.
CONCLUSIONS
At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.
背景
许多利益相关者对公众就卫生政策问题表达意见的能力几乎没有信心，或完全没有信心。人们常常声称，外行人根据自身个人经历来确定优先事项，可能缺乏理解广大民众需求所需的广阔视角。为了实证检验这一说法，本研究将公众在个人保险方面的优先事项与其在国家卫生资源分配方面的优先事项进行了比较。因此，该研究应能阐明公众在国家层面的优先事项在多大程度上反映了其个人层面的优先事项。
方法
对18岁及以上的以色列成年人口代表性样本（n = 1,225）进行了电话调查。通过要求受访者假设自己是卫生部长，并从这个角度在各个卫生领域分配额外预算，来评估公众的优先事项。通过要求受访者选择纳入其个人补充健康保险的首选项目，来评估他们在个人层面的优先事项。
结果
超过一半的受访者（54%）表达了不同的个人和国家优先事项。在多变量逻辑分析中，“人群组”是唯一具有统计学意义的变量；犹太人对两个问题给出相似回答的可能性是阿拉伯人的1.8倍。收入水平具有临界显著性。
结论
至少一半的人口能够区分他们的个人需求和国家政策需求。我们不主张基于民意调查或公投的决策过程。然而，我们认为应该允许人们表达他们对国家政策问题的优先事项，并且决策者应该将这些作为用于确定政策决策的因素之一加以考虑。
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