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権力 が 行動 に どの よう に 影響 を 与える か:医師 たち の 証拠
Stephen D Schwab1, Manasvini Singh2
1Department of Management, University of Texas at San Antonio, San Antonio, TX, USA.
まとめ
医者のパワーダイナミクスは 医療に大きな影響を与えます 高効能の患者はよりよい治療と治療結果を得ますが 低効能の患者は特に 医者が高効能の患者を治療する場合に 苦しむことがあります
科学分野:
- 医学社会学
- 医療サービス研究
- 組織的行動
背景:
- 権力差は社会的なやり取りに浸透し 資源の配分と結果に影響を与えます
- 医療におけるパワーダイナミクスを研究することは 患者の健康に与える影響のために 極めて重要です
- 医者と患者の関係は 権力の影響を調べる上で重要な文脈です
研究 の 目的:
- 医者と患者の力の差が 医者の行動と患者の結果に与える影響を調査する
- 患者の力のレベルが 異なった場合の影響を 量化するために
- 患者ランク,昇進,並列の患者負担などの要因が医療リソースの割り当てにどのように影響するか確認する.
主な方法:
- アメリカ軍の緊急部門で 150万件の準ランダムな割り当てを活用した.
- 医者と患者の間の 軍事的階級の格差を用いて 力の差を測った
- 医者の行動と患者の成果を 分析した
主要な成果:
- 強力な患者 (医師を上回る) はより多くのリソースを受け,より良い健康結果を体験しました.
- 医者の努力は 患者の昇進とともに増加し 権力への反応を示しています
- 低パワーの患者は 医者が同時に高パワーの患者さんを 治療したときに 否定的な結果を経験しました
- 医師と患者の間の人種と性との一致も 治療のダイナミクスに影響を与えました
結論:
- 医師と患者の関係における力の不均衡は 医療の提供に重大な,しばしば有害な変化をもたらします
- 脆弱な集団,特に 弱体な患者は,これらの弱体化による格差によって不釣り合いな被害を受けています.
- 公平な医療成果を推進し 患者の福祉を守るために 権力ダイナミクスの対処は不可欠です
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