“以人为本”的医疗保健方法的价值意义

J. Pierron, Didier Vinot
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引用次数: 4

摘要

在卫生经济学中,价值通常在医疗保健的生产和消费框架内被理解。效率和公平这两种衡量工具被用于医疗资源决策。然而,卫生保健系统也不像其他系统那样是一个市场,将效率和公平的标准应用于卫生领域需要进行重大调整。此外,即使在认识论和技术装备上,护理也是对被护理对象的关注和参与。目前的模型没有考虑到个体患者经验的定性性质,也没有考虑到影响患者健康结果的更广泛的环境。因此,在健康经济学角度理解的价值和以人为本的护理建议中促进的关系价值之间,紧张关系继续存在。医疗保健价值观是多元的,解释了一个人在行动和与他人的关系方面的承诺。考虑到这种多元性,我们不仅想到了护理的道德层面,而且也想到了如何通过筹资实现护理。因此,以人为本的护理需要新的评估模式,这些模式将理解在个人和专业背景下对人的护理的价值。
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The Meaning of Value in “Person-centred” approaches to Healthcare
In health economics, value has usually been understood within the framework of the production and consumption of healthcare. Two tools of measurement, efficiency and equity, have been used to make decisions on healthcare resources. However, the healthcare system is also not a market like others, and applying the criteria of efficiency and equity to the field of health calls for significant adaptation. In addition, even when epistemologically informed and technically equipped, care is also attention and an engagement toward the person for whom the care is directed.  Current models fail to take into consideration the individual, qualitative nature of individual patient experience, but also the wider environment affecting the patient’s health outcomes. Therefore tensions continue to exist between value as understood in a health economics perspective and the relational values promoted in proposals of person-centered care. Healthcare values are plural and explain what one commits to in terms of actions and relationships with others. Taking into account this plurality reminds us both of the ethical dimension of care but also how it is made possible through financing. Person-centered care therefore calls for new models of evaluation, ones which will understand the values of care for the person in their personal and professional contexts.
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