Importance Philanthropy is an increasingly important source of support for health care institutions. There is little empirical evidence to inform ethical guidelines. Objective To assess public attitudes regarding specific practices used by health care institutions to encourage philanthropic donations from grateful patients. Design, Setting, and Participants Using the Ipsos KnowledgePanel, a probability-based sample representative of the US population, a survey solicited opinions from a primary cohort representing the general population and 3 supplemental cohorts (with high income, cancer, and with heart disease, respectively). Exposures Web-based questionnaire. Main Outcomes and Measures Descriptive analyses (with percentages weighted to make the sample demographically representative of the US population) evaluated respondents' attitudes regarding the acceptability of strategies hospitals may use to identify, solicit, and thank donors; perceptions of the effect of physicians discussing donations with their patients; and opinions regarding gift use and stewardship. Results Of 831 individuals targeted for the general population sample, 513 (62%) completed surveys, of whom 246 (48.0%) were women and 345 (67.3%) non-Hispanic white. In the weighted sample, 47.0% (95% CI, 42.3%-51.7%) responded that physicians giving patient names to hospital fundraising staff after asking patients' permission was definitely or probably acceptable; 8.5% (95% CI, 5.7%-11.2%) endorsed referring without asking permission. Of the participants, 79.5% (95% CI, 75.6%-83.4%) reported it acceptable for physicians to talk to patients about donating if patients have brought it up; 14.2% (95% CI, 10.9%-17.6%) reported it acceptable when patients have not brought it up; 9.9% (95% CI, 7.1%-12.8%) accepted hospital development staff performing wealth screening using publicly available data to identify patients capable of large donations. Of the participants, 83.2% (95% CI, 79.5%-86.9%) agreed that physicians talking with their patients about donating may interfere with the patient-physician relationship. For a hypothetical patient who donated $1 million, 50.1% (95% CI, 45.4%-54.7%) indicated it would be acceptable for the hospital to show thanks by providing nicer hospital rooms, 26.0% (95% CI, 21.9%-30.1%) by providing expedited appointments, and 19.8% (95% CI, 16.1%-23.5%) by providing physicians' cell phone numbers. Conclusions and Relevance In this survey study of participants drawn from the general US population, a substantial proportion did not endorse legally allowable approaches for identifying, engaging, and thanking patient-donors.

中文翻译：

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公众对医院和医生鼓励感恩患者捐赠的态度

重要性 慈善事业是医疗保健机构越来越重要的支持来源。几乎没有经验证据可以为道德准则提供信息。目的 评估公众对卫生保健机构鼓励感恩患者慈善捐赠的具体做法的态度。设计、设置和参与者 使用 Ipsos KnowledgePanel（一个代表美国人口的基于概率的样本），一项调查从代表一般人群的主要队列和 3 个补充队列（高收入、癌症和心脏病、分别）。曝光基于网络的问卷。主要结果和措施 描述性分析（加权百分比以使样本在人口统计上代表美国人口）评估了受访者的 关于医院可能用来识别、征求和感谢捐赠者的策略的可接受性的态度；对医生与患者讨论捐赠的影响的看法；以及关于礼物使用和管理的意见。结果 在针对一般人群样本的 831 人中，513 人 (62%) 完成了调查，其中 246 人 (48.0%) 为女性，345 人 (67.3%) 为非西班牙裔白人。在加权样本中，47.0% (95% CI, 42.3%-51.7%) 表示医生在征得患者同意后向医院筹款人员提供患者姓名是肯定或可能可以接受的；8.5% (95% CI, 5.7%-11.2%) 在未经许可的情况下认可推荐。在参与者中，79.5% (95% CI, 75.6%-83.4%) 表示，如果患者提出捐赠，医生与患者谈论捐赠是可以接受的；14.2%（95% CI，10。9%-17.6%) 表示在患者未提出时可以接受；9.9% (95% CI, 7.1%-12.8%) 接受医院发展人员使用公开数据进行财富筛查，以确定能够进行大额捐赠的患者。在参与者中，83.2%（95% CI，79.5%-86.9%）同意医生与患者谈论捐赠可能会干扰医患关系。对于捐赠 100 万美元的假设患者，50.1%（95% CI，45.4%-54.7%）表示医院通过提供更好的病房表示感谢是可以接受的，26.0%（95% CI，21.9%-30.1 %) 通过提供加急预约，19.8% (95% CI, 16.1%-23.5%) 通过提供医生的手机号码。结论和相关性 在这项针对来自美国一般人群的参与者的调查研究中，