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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。
OBJECTIVE: To initially discuss the impact of the setting of medical resources allocation plan and the frame description on people’s perception of fairness. Methods: Taking 120 undergraduates as research objects, the author made a questionnaire about the situation of health care. According to Miller ’s definition of equality, demand, responsibility and payout principle, it formulated the distribution plan of medical resources, which was described by positive, negative and equilibrium framework. The subjects were randomly divided into three groups. Each group of subjects needed to assess the fairness of the four distribution schemes under the same framework. Results: The results showed that the main effect of the distribution program was significant (F = 7.27, P <0.01). The distribution of medical resources according to the principle of demand was not fair (t = -2.04, P <0.01) The trial felt fair (t = 2.87, P <0.01). There was no significant fairness or unfairness among participants (P> .05) based on the principle of accountability and equality. The main effect of the frame description was significant (F = 6.08, P <.05), which was described by the positive frame. The assessment of fairness was significantly higher than the balance frame and the negative frame. The interaction between the frame description and the distribution principle was significant (F = 3.93, P <0.01). Under the positive framework, the distribution program effect was not significant (F = 1.29, P> 0.05). Under the negative framework and the balance framework, (F balance = 9.23, P <0.01; F negative = 4.69, P <0.01). The distribution plan based on on-demand and on-demand principles was influenced by the framework (F = 12.88, P <0.01; F = 4.12, P <0.05), whereas the principle of equal distribution did not Affected by the description of the framework. Conclusion: The principle of distribution and the description of the framework can significantly affect people’s fair perception of the distribution of medical resources.