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The costs of risk and fear: a qualitative study of risk conceptualisations in allied health resource allocation decision-making
Health, Risk & Society ( IF 2.659 ) Pub Date : 2019-09-22 , DOI: 10.1080/13698575.2019.1667962
Kellie Grant 1 , Jenni White 2, 3 , Jenny Martin 4 , Terry Haines 1
Affiliation  

Over the past several decades, the paradigm of risk has become increasingly salient for understanding how health care is provided. In more recent years, we have seen an expanding body of literature raising concerns of possible harms that a focus on risk may carry. Despite considerable research interest in risk, relatively little is known about the construction of risk in contexts of allied health resource allocation decision-making. This article reports on qualitative research exploring how allied health leaders construct the concept of risk and how this influences resource allocation decision-making. Data are drawn from forums held in August and September 2014, with a total of 59 participants who occupied leadership roles in allied health in Australia. The findings highlight three domains of risk: resource, patient and organisational risk. Some domains of risk received more attention from participants and exerted greater influence on decision-making than others. Relative to the other domains, patient risk was not a core focus. Risk had a distinct emotive element and some domains of risk led participants to focus on catastrophic outcomes. Patient risk did not evoke emotive responses, whereas both resource and organisational risk did. It appears that perceived risk may be costly for health organisations, as it can be a primary driver underpinning resource allocation decisions. We explore the relative lack of attention to patient risk, the role of fear and anxiety in decision-making, and discuss implications of the impact of a focus on risk in wider society.



中文翻译:

风险和恐惧的代价:有关卫生资源分配决策中风险概念的定性研究

在过去的几十年中,风险范式对于了解如何提供医疗保健变得越来越重要。近年来,我们已经看到越来越多的文献提出了对风险的关注可能带来的危害。尽管对风险的研究兴趣很大,但在相关卫生资源分配决策的背景下,关于风险构建的知识知之甚少。本文对定性研究进行了报道,探讨了盟国卫生领导人如何构建风险概念以及这如何影响资源分配决策。数据来自2014年8月和9月举行的论坛,共有59名参与者在澳大利亚的专职医疗中担任领导角色。调查结果突出了三个风险领域:资源,患者和组织风险。一些风险领域比其他风险领域更受参与者关注,并且对决策的影响更大。相对于其他领域,患者风险并不是重点。风险具有独特的情感因素,并且某些风险领域使参与者专注于灾难性结果。患者风险并未引起情绪反应,而资源风险和组织风险均如此。看来,对于卫生组织而言,感知到的风险可能代价高昂,因为它可能是支撑资源分配决策的主要驱动力。我们探讨了相对缺乏对患者风险的关注,恐惧和焦虑在决策中的作用,并讨论了在更广泛的社会中关注风险的影响的含义。相对于其他领域,患者风险并不是重点。风险具有独特的情感因素,并且某些风险领域使参与者专注于灾难性结果。患者风险并未引起情绪反应,而资源风险和组织风险均如此。看来,对于卫生组织而言,感知到的风险可能代价高昂,因为它可能是支撑资源分配决策的主要驱动力。我们探讨了相对缺乏对患者风险的关注,恐惧和焦虑在决策中的作用,并讨论了在更广泛的社会中关注风险的影响的含义。相对于其他领域,患者风险并不是重点。风险具有独特的情感因素,并且某些风险领域使参与者专注于灾难性结果。患者风险并未引起情绪反应,而资源风险和组织风险均如此。看来,对于卫生组织而言,感知到的风险可能代价高昂,因为它可能是支撑资源分配决策的主要驱动力。我们探讨了相对缺乏对患者风险的关注,恐惧和焦虑在决策中的作用,并讨论了在更广泛的社会中关注风险的影响的含义。而资源和组织风险都可以。看来,对于卫生组织而言,感知到的风险可能代价高昂,因为它可能是支撑资源分配决策的主要驱动力。我们探讨了相对缺乏对患者风险的关注,恐惧和焦虑在决策中的作用,并讨论了在更广泛的社会中关注风险的影响的含义。而资源和组织风险都可以。看来,对于卫生组织而言,感知到的风险可能代价高昂,因为它可能是支撑资源分配决策的主要驱动力。我们探讨了相对缺乏对患者风险的关注,恐惧和焦虑在决策中的作用,并讨论了在更广泛的社会中关注风险的影响的含义。

更新日期:2019-09-22
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