Article information
Resumen
La necesidad de mejorar la participación colectiva en la toma de decisiones en sanidad es una de las principales líneas de reforma de los sistemas sanitarios financiados colectivamente. En este artículo se analizan los argumentos, las formas y los mecanismos de participación colectiva aplicables a la toma de decisiones en sanidad. Por otra parte, se examinan los métodos de obtención de preferencias sobre programas financiados por el sistema sanitario. Se revisan los principales métodos de obtención de preferencias para establecer prioridades en los sistemas públicamente financiados. Por último, se sugieren algunas líneas de actuación en España.
Palabras clave:
Participación colectiva
Obtención de preferencias
Programas sanitarios
Abstract
The need to increase collective participation in health care decision-making is one of the main health reform issues in publicly financed health systems. The present article examines the arguments for collective participation, the means for improving it and the methods available to elicit collective preferences concerning health programs to be financed by the health system. We review the various collective participation tools, as well as the preference elicitation methods assist priority setting in collectively funded health care systems. Finally, the paper suggests some policy implications for policy making design in Spain.
Key words:
Collective participation
Preference elicitation
Health care programs
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Bibliografía
[1.]
J. Costa-Font.
Establecimiento de prioridades, participación colectiva y decisión pública en sanidad. Información Comercial Española.
Revista de Economía, 804 (2003), pp. 141-155
[2.]
H.J. Sutherland, J.E. Till.
Quality of life assessment and levels of decision making: differetiating objectives.
Quality Life Res, 2 (1993), pp. 297-303
[3.]
M. Ryan, D.A. Scott, C. Reeves, A. Bate, E.R. Teijlingen, H. Russell, et al.
Eliciting public preferences for health care: a systematic review of techniques.
Health Technology Assessment, 5 (2001), pp. 1-186
[4.]
M. Olson.
The logic of collective action.
Harvard University Press, (1970),
[5.]
A. Hirchsman.
Exit, voice and Loyalty: responses to decline in firms, organizations and states.
Harvard University Press, (1970),
[6.]
J. Lomas.
Reluctant rationers: public input to health care priorities.
J Health Serv Res Policy, 2 (1997), pp. 103-111
[7.]
D. Price.
Choices without reasons: citizens juries and policy evaluation.
J Medical Ethics, 26 (2000), pp. 272-276
[8.]
L. Lomansky, G. Brennan.
Democracy and decision.
The pure theory of electoral preference, Cambridge University Press, (1993),
[9.]
A. Coote, J. Lennaghan.
Citizen's juries: theory into practice.
Institute for Public Policy Research, (1997),
[10.]
D. Hadorn.
The role of public values in setting health care priorities.
Soc Sci Med, 32 (1991), pp. 773-781
[11.]
E. Nord, Cost-value analysis in health care.
Making sense out of QALYs.
Cambridge University Press, (1999),
[12.]
G. Mooney.
Economics, comunitarism and health care.
Health, health care and health economics: perspectives on distribution,
[13.]
H. Margolis.
Selfishness, altruism and rationality.
Cambridge University Press, (1982),
[14.]
A. Shell, P. Hawe.
Health promotion community development and the tyranny of individualism.
Health Economics, 5 (1996), pp. 241-247
[15.]
P. Dolan, J.A. Olsen, P. Menzel, J. Richardson.
2003. An Inquiry into the different perspectives that can be used when eliciting preferences in health.
Health Economics, 12 (2003), pp. 545-551
[16.]
G. Mooney, M. Lange.
Ante-natal screening: what constitutes a benefit?.
Soc Sci Med, 37 (1993), pp. 873-878
[17.]
A. Wagstaff.
QALYs and the Equity-Efficiency Trade-Off.
J HealthEconomics, 10 (1991), pp. 21-41
[18.]
J.M. Abellan, J.L. Pinto.
Health state after treatment: a reason for discrimination?.
Health Economics, 8 (1999), pp. 701-707
[19.]
P. Dolan.
Measurement of Individual Utility and Social Welfare.
J Health Economics, 12 (1998), pp. 431-457
[20.]
H. Bleichrodt.
Health utility and equity considerations.
J Health Economics, 16 (1997), pp. 65-91
[21.]
J. Donovan, J. Coast.
Public participation in priority setting: commitment or illusion?.
Priority setting: the health debate, pp. 203-234
[22.]
E. Nord, J.L. Pinto, J. Richardson, P. Menzel, P. Ubel.
Incorporating societal concerns for fairness in numerical valuations of health programs.
Health Economics, 8 (1999), pp. 25-39
[23.]
M.A. Strosberg, J.M. Wiener, R. Backer, I.A. Fein.
Rationing Americas Medical Care: the Oregon plan and beyond,
[24.]
C. Bowie, A. Richardson, S. Sykes.
Consulting the public about health service priorities.
BMJ, 311 (1995), pp. 1155-1158
[25.]
P. Cookson, P. Dolan.
Public views on health care rationing: a group discussion study.
Health Policy, 49 (1999), pp. 63-74
[26.]
J. Lenaghan.
Involving the public in rationing decisions. The experience of citizens juries.
Health Policy, 49 (1999), pp. 45-61
[27.]
J. Lenaghan, B. New, E. Mitchell.
Setting priorities: is there a role for citizen's juries?.
BMJ, (1996), pp. 1591-1593
[28.]
J. Coast.
Core services: pluralistic bargaining in New Zealand.
Priority setting: the health debate, pp. 65-82
[30.]
A. Richardson, M. Charny, D. Hanmer-Lloyd.
Public opinion and purchasing.
BMJ, 304 (1992), pp. 680-682
[31.]
A. Dicker, D. Amsotrong.
Patient's views of priority setting in health care: an interview survey in one practice.
BMJ, 311 (1995), pp. 1137-1139
[32.]
J.F. Guest, W.H. Hart, R.F. Cookson.
Cost analysis of palliative care for terminally ill cancer patients in the UK after switching from weak to strong episodes.
Phamacoeconomics, 30 (1998), pp. 665-678
[33.]
NHS Management Executive.
Local voices: the views of local people in purchasing for health.
Management Executive, (1992),
[34.]
E. Rodríguez.
La valoración social como guía en el establecimiento de prioridades sanitarias; [tesis doctoral].
Universidad Complutense, (2001),
[35.]
J.L. Pinto, E. Rodríguez, X. Castells, X. García, F.I. Sánchez.
El establecimiento de prioridades en cirugía electiva.
Ministerio de Sanidad y Consumo y CRES, (2000),
[36.]
J.L. Pinto, R. Rodríguez.
¿Cuánto vale la pena gastarse para ganar un año de vida ajustado por calidad? Un estudio empírico.
El valor monetario de la salud,
[37.]
Costa-Font J. Conducta individual, assegurament i el·lecció colectiva: una aplicació a la política sanitaria; [tesis doctoral]. Barcelona: Universitat de Barcelona; 1999.
[38.]
Puig J, Dalamau E. Una revisión del método de la valoración contingente en salud. Aspectos metodológicos, problemas prácticos y aplicaciones en España. Hacienda Pública Española, N.° 154-3/2000.
[39.]
A. Thompson, J. Espluga, M. Alonso.
Participació ciutadana en la provisió de serveis de salut..
Expectativas i mecanimes efectius dels ciutadans i les ciutadanes de catalunya per influir en la provisió i millora dels serveis públics de salut, Servei Català de la Salut, Conèixer 2, (1999),
[40.]
A. Martin Serrano.
The participation of the user in the improvement of health services. An opinion poll conducted at the Nuestra Señora de Sonsoles Hospital of Insalud in Ávila.
Rev Enferm, 13 (1990), pp. 48
[41.]
L. Canada Royo.
Community participation in health planning.
Rev Sanid Hig Publica (Madr), 54 (1980), pp. 521-536
[42.]
A. Delgado, L.A. López Fernández.
Community participation: a necessary review.
Aten Primaria, 9 (1992), pp. 457-459
[43.]
A. Uriarte Rodríguez, J.L. Ruiz-Giménez Aguilar.
The organization of a health center starting with citizen participation. The example of the Centro de Salud Vicente Soldevilla.
Aten Primaria, 11 (1993), pp. 253-257
[44.]
R. Bostic, R.J. Herrnstein, R.D. Luce.
The effect of preference revearsal using choice indifferences.
J Econ Beh Org, 13 (1990), pp. 193-212
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