【摘要】 目的:初步探讨医疗资源分配方案设置及框架描述对人们感知公平的影响。方法:以120名大学生为研究对象,自编情境问题,分别依据Miller定义的平等、需求、责任及付出原则制定医疗资源分配分配方案,采用正、负及平衡框架进行描述。被试被随机分为三组,每组被试需要评估同一框架下,四种分配方案的公平性。结果:结果显示,分配方案主效应显著(F=7.27,P<0.01),按照需求原则分配医疗资源,被试感到不公平(t=-2.04,P<0.01),而以付出原则分配,被试感到公平(t=2.87,P<0.01),以按责与平等原则分配,被试没有显著的公平或不公平感(P>.05)。框架描述主效应显著(F=6.08,P<.05),以正框架描述,公平感评估显著高于平衡框架与负框架。框架描述与分配原则交互作用显著(F=3.93,P<0.01),在正框架下,分配方案效应不显著(F=1.29,P>0.05),在负框架与平衡框架下,分配方案效应显著(F平衡=9.23,P<0.01;F负=4.69,P<0.01)。依据按需与按责原则制定的分配方案受到框架描述影响(F按需=12.88,P<0.01;F按责=4.12,P<0.05),而依据平等原则、付出原则制定的分配方案不会受到框架描述的影响。结论:分配原则及框架描述均能显著影响人们对医疗资源分配的公平感知。更多还原

【Abstract】 Objective: To preliminarily explore the impact of resource allocation principles and framing description on the perceived fairness in the medical situation. Methods: Established medical resource allocation problems based on the theory of justice proposed by Miller concerning need, equality, effort and merit principles. All the allocation plans were described in positive, negative or neutral frames. 120 volunteers were randomly assigned to 3 groups. Every volunteer completed the perceived fairness evaluations of the four allocation plans described in one frame. Results: The main effect of resource allocation principles on perceived fairness was significant(F=7.27, P<0.01). Subjects felt unfair for the allocation plan based on need principle(t=-2.04, P<0.01) and fair based on effort principle(t=2.87, P<0.011). But there were no significant perceived fairness or unfairness for allocation plan based on merit or equality principles. There was a significant framing effect in perceived fairness(F=6.08, P<0.05). Compared to negative or neutral frames, when the plans were described in positive frames, people would feel more faire. There was a significant interaction between framing description and allocation principles(F=3.93, P<0.01). The effect of allocation principles was not significant in positive frame(F=1.29, P>0.05) but significant in both negative(F=4.69, P<0.01) and neutral(F=9.23, P<0.01) frames. Framing effect were found in allocation plans according to need and merit principles but not significant according to equality or effort principles. Conclusion: Both framing description and allocation principles could influence the perceived fairness in the medical situation.更多还原