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首页> 外文期刊>Journal of health services research & policy >Divergence of NHS choice policy in the UK: What difference has patient choice policy in England made?
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Divergence of NHS choice policy in the UK: What difference has patient choice policy in England made?

机译：英国NHS选择政策的分歧：英国的患者选择政策有何不同？

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Objectives: To examine the types of choices available to patients in the English NHS when being referred for acute hospital care in the light of the divergence of patient choice policy in the four countries of the UK. Methods: Case studies of eight local health economies in England, Scotland, Northern Ireland and Wales (two in each country); 125 semi-structured interviews with staff in acute services providers, purchasers and general practitioners (GPs). Results: GPs and providers in England both had a clear understanding of the choice of provider policy and the right of patients to choose a provider. Other referral choices potentially available to patients in all four countries were date and time of appointment, site and specialist. In practice, the availability of these choices differed between and within countries and was shaped by factors beyond choice policy, such as the number of providers in an area. There were similarities between the four countries in the way choices were offered to patients, namely lack of clarity about the options available, limited discussion of choices between referrers and patients, and tension between offering choice and managing waiting lists. Conclusions: There are challenges in implementing pro-choice policy in health care systems where it has not traditionally existed. Differences between England and the other countries of the UK were limited in the way choice was offered to patients. A cultural shift is needed to ensure that patients are fully informed by GPs of the choices available to them.
机译：目的：根据英国四个国家/地区患者选择政策的差异，研究在转诊为急诊医院护理时，英语NHS中可供患者选择的类型。方法：对英格兰，苏格兰，北爱尔兰和威尔士（每个国家两个）的八个地方卫生经济体进行案例研究;与急性服务提供者，购买者和全科医生的工作人员进行125次半结构化访谈。结果：英格兰的全科医生和医疗提供者对医疗提供者政策的选择以及患者选择医疗提供者的权利都有清晰的了解。所有四个国家/地区的患者都可以选择的其他转诊选择包括约会的日期和时间，地点和专科医生。实际上，这些选择的可用性在国家之间和国家内部是不同的，并且受选择政策之外的因素影响，例如某个地区中提供者的数量。四个国家在向患者提供选择的方式方面存在相似之处，即对可用选择的认识不明确，推荐人和患者之间选择的讨论有限，以及提供选择和管理等待名单之间的紧张关系。结论：在传统上不存在的保健系统中，实施选择支持政策存在挑战。英格兰与英国其他国家之间的差异在为患者提供选择的方式上受到限制。需要进行文化上的转变，以确保GP可以向患者充分告知患者可用的选择。

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