Rationing Constructed Realitie

ISBN-13: 9780631228578 / Angielski / Miękka / 2002 / 216 str.

Andrew Light; David Hughes; Donald Light

Opis

This volume contributes to the ongoing debate about healthcare rationing by bringing together case studies of resource allocation at different levels of the healthcare system. Drawing on research from the United Kingdom, Europe and North America, it examines issues such as prioritisation and access to care in a range of hospital and community settings.

Spis treści

Notes on Contributors.

1. Introduction. A sociological perspective on rationing: power, rhetoric and situated practices (Donald Light and David Hughes).

2. Risk and Rationing. Rationing through risk assessment in clinical genetics: all categories have wheels (Lindsay Prior).

3. Governmentality and risk: setting priorities in the new NHS (Paul Joyce).

4. Rationing in Hospitals. Categorisation and micro–rationing: access to care in a French emergency department (Carine Vassy).

5. Everyday experiences of implicit rationing: comparing the voices of nurses in California and British Columbia (Ivy Lynn Bourgeault, Pat Armstrong, Hugh Armstrong, Jacqueline Choiniere, Joel Lexchin, Eric Mykhalovskiy, Suzanne Peters and Jerry White).

6. Rationing in the Community. Rationing health car to disabled people (Gary L. Albrecht).

7. Categorising to exclude: the discursive construction of cases in community mental health teams (Lesley Griffiths).

8. Professional Resistance. Subverting criteria: the role of precedent in decisions to finance surgery (John Heritage, Elizabeth Boyd and Lawrence Kleinman).

9. Clinical actions and financial constraints: the limits to rationing intensive care (Irvine Lapsley and Kath Melia).

Index.

O autorze

David Hughes is a Professor in the School of Health Science at the University of Wales Swansea and Dean of the Faculty of Education and Health Studies. His current research interests include the reformed NHS, health care rationing and the changing division of health labour. He has written on a range of topics in the fields of medical sociology, socio–legal studies and health policy.

Donald W. Light is the Professor of comparative health care systems at the University of Medicine and Dentistry of New Jersey and a fellow at the Center for Bioethics at the University of Pennsylvania. Trained as a sociologist at the University of Chicago and Brandeis, he is a Faculty Associate in the Department of Sociology at Princeton University. Professor Light has written about distributive justice in the BMJ and is co–author of Benchmarks of Fairness for Health Care Reform (1996).

Blurb

This volume examines health care rationing in action using recent case studies from the United Kingdom, Europe and North America. Drawing on data from a variety of hospital and community settings, the contributors show how prioritisation and access to care depend on organisational arrangements and professional practices, which are often invisible to the service user.

Unusually for a book on this topic, many of the chapters provide detailed accounts of micro–level decision making at the point of service delivery. They seek to penetrate the ′black box′ of the organisation – the emergency department, the intensive care unit, the cancer genetics clinic or the community mental health team – to shed light on processes by which access to care is denied, delayed, or otherwise limited. The book presents a picture of rationing processes that are ′implicit′ rather than ′explicit′, and closely woven into the fabric of professional cultures and modes of working.