高齢の患者は,心臓診療の列に並ぶ若い患者のために脇に立つのでしょうか?
A Mariotto1, D De Leo, M D Buono
1Unit for Technology Assessment and Quality Assurance, Medical Directorate, Padova, Italy. farmosp16@pd.nettuno.it
Lancet (London, England)
|August 28, 1999
まとめ
年配のイタリア人は,若者や就職者のために,心臓治療の列の席をあきらめようとした. しかし,若い人は,医療の優先順位を譲る意欲が弱かった.
科学分野:
- 医療倫理 医療倫理について
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
- 公共衛生政策 公共衛生政策
背景:
- 公正な病院のキュー管理には,臨床的必要性を考慮する必要があります.
- 非臨床的優先要因 (年齢,雇用) に関する公衆の態度は,ほとんど知られていない.
- 公衆の認識を理解することは,公平な医療へのアクセスに不可欠です.
研究 の 目的:
- ヘルスケアキューの優先順位付けにおける非臨床的要因に対する公衆の態度を調査する.
- 高齢者の心臓ケアにおける優先順位を譲る意思を評価する.
- 医療へのアクセスの公平性に関する高齢者と非高齢者の見解を比較する.
主な方法:
- イタリアのパドヴァの高齢住民に実施された調査.
- 参加者は,心臓外科手術や診察の際の列の位置を譲ることについて質問しました.
- 高齢者と若い医療従事者の回答を比較する (高齢者の役割を想像する).
主要な成果:
- 回答者の約50%の高齢者は,心臓外科手術の優先順位を若者/自営業者に譲るだろう.
- 68%以上が,外来心臓病診療の優先順位を譲ります.
- 既婚者,退職寸前者,大学教育を受けた者,かつては自営業していた高齢者は,優先順位を譲る意欲が弱かった.
- 高齢者でない回答者は,すべてのシナリオで優先順位を譲ることを圧倒的に拒否しました.
結論:
- 高齢者は,心臓ケアへのアクセスを優先する仮説的な意思を示しています.
- この意欲は,高齢者の年齢が若くなり,社会経済的地位が高くなるにつれ減少する.
- 若年層の住民は,ヘルスケアキューの優先順位に関して,利他主義が著しく低いことを示しています.
- 将来の医療政策では,高齢者集団が自らの権利を主張する確固たる姿勢を強める可能性を考慮する必要があるかもしれない.
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