Priority Setting and Rationing in Primary Health Care
نویسندگان
چکیده
3 List of Papers 5 Abbreviations 7 Background 9 Introduction 9 Priority setting and rationing – why and what it is 10 Aspects of priority setting and rationing 12 Priority setting at different levels 14 Vertical and horizontal priority setting 14 Explicit and implicit priority setting 15 Central components in priority setting 16 Facts 16 Values 17 Process 18 Synthesis 20 Priority setting in Sweden 21 Ethical platform 21 Priority setting groups 22 The national model for priority setting 23 Primary health care and priority setting 26 Experiences from priority setting in primary health care 29 Aims 31 Material and methods 33 Study population and material 33 Qualitative analyses 38 Statistics 39 Ethics 40 Results 41 Paper I 41 Paper II 44 Paper III 47 Paper IV 48 General Discussion 51 Priority setting and rationing in day-to day care 51 Patients’ demands and (un)acceptance of priority setting 54 Using the Swedish priority setting criteria 55 Additional aspects of the priority setting criteria 57 Use of the criteria at the individual level 61 Patients’ and medical staff’s priority setting 61 Implications at the system level 62 Open priority setting and rationing 64 Group level 64 Individual level 64 Priority setting objects and guidelines 66 Shared responsibility in priority setting 68 Methodological considerations 70 The qualitative studies (Papers I and IV) 70 The quantitative studies (Paper II and III) 74 Future research 77 Conclusions 79 Svensk sammanfattning 81 Acknowledgements 85 Appendixes 89 Appendix A 90 Appendix B 93 References 95
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