Resource allocation and rationing in nursing care: A discussion paper

被引：84

作者：

Scott, P. Anne ^{[1
]}

Harvey, Clare ^{[2
]}

Felzmann, Heike ^{[1
]}

Suhonen, Riitta ^{[3
,4
]}

Habermann, Monika ^{[5
]}

Halvorsen, Kristin ^{[6
]}

Christiansen, Karin ^{[7
]}

Toffoli, Luisa ^{[8
]}

Papastavrou, Evridiki ^{[9
]}

Evridiki, Papastavrou ^{[9
]}

Chryssoula, Lemonidou ^{[10
]}

Walter, Sermeus ^{[11
]}

Maria, Schubert ^{[12
]}

Riitta, Suhonen ^{[13
]}

Olga, Riklikiene ^{[14
]}

Rengin, Acaroglu ^{[15
]}

Panayiota, Andreou ^{[9
]}

Darijana, Antonic ^{[16
]}

Dietmar, Ausserhofer ^{[17
]}

Christophe, Baret ^{[18
]}

Helen, Bosch-Leertouwer ^{[12
,19
]}

Helga, Bragadottir ^{[20
]}

Luk, Bruyneel ^{[21
]}

Karin, Christiansen ^{[7
]}

Ruta, Ciutiene ^{[22
]}

Raul, Cordeiro ^{[23
]}

Liana, Deklava ^{[24
]}

Suzanne, Dhaini ^{[25
]}

Anat, Drach-Zahavy ^{[26
]}

Georgios, Eftathiou ^{[9
]}

Sigal, Ezra ^{[27
]}

Fuster, Pilan ^{[28
]}

Joanna, Gotlib ^{[29
]}

Elena, Gurkova ^{[30
]}

Monika, Habermann ^{[31
]}

Kristin, Halovsen ^{[6
]}

Patti, Hamilton ^{[32
]}

Clare, Harvey ^{[33
]}

Saima, Hinno ^{[34
]}

Ingibjorg, Hjaltadottir ^{[20
]}

Darja, Jarosova ^{[35
]}

Terry, Jones ^{[36
]}

Raphaela, Kane ^{[37
]}

Marcia, Kirwan ^{[38
]}

Helena, Leino-Kilpi ^{[13
]}

Marcel, Leppee ^{[39
]}

Mario, Amorim Lopes ^{[40
,41
]}

Diaz Cristobal, Rengel ^{[42
]}

Christian, Rochefort ^{[43
]}

Anne, Scott P. ^{[1
]}

机构：

[1] Natl Univ Ireland, Univ Rd, Galway H91 TK33, Ireland

[2] Cent Queensland Univ, Rockhampton, Qld, Australia

[3] Univ Turku, Turku Univ Hosp, Turku, Finland

[4] City Turku Welf Div, Turku, Finland

[5] City Univ Appl Sci, Hsch Bremen, Bremen, Germany

[6] Oslo Metropolitan Univ, Oslo, Norway

[7] VIA Univ Coll, Horsens, Denmark

[8] Univ South Australia, Adelaide, SA, Australia

[9] Cyprus Univ Technol, Limassol, Cyprus

[10] Univ Athens, Athens, Greece

[11] Leuven Inst Healthcare, Leuven, Belgium

[12] Univ Basel, Basel, Switzerland

[13] Univ Turku, Turku, Finland

[14] Lithuanian Univ Hlth Sci, Kaunas, Lithuania

[15] Istanbul Univ, Istanbul, Turkey

[16] Publ Hlth Inst, Banja Luka, Republic Of Srp, Bosnia & Herceg

[17] Landesfachhsch GesundheitsberufeClaudiana, Bolzano, Italy

[18] CNRS, LEST, Paris, France

[19] Windesheim Univ Appl Sci, Zwolle, Netherlands

[20] Univ Iceland, Reykjavik, Iceland

[21] Katholieke Univ Leuven, Leuven, Belgium

[22] Kaunas Univ Technol, Kaunas, Lithuania

[23] Inst Politecn Portalegre, Porto Alegre, RS, Brazil

[24] Riga Stradins Univ, Riga, Latvia

[25] Amer Univ Beirut, Beirut, Lebanon

[26] Univ Haifa, Haifa, Israel

[27] Sheba Hosp, Sheba Med Ctr, Ramat Gan, Israel

[28] Univ Int Catalunya, Barcelona, Spain

[29] Med Univ Warsaw, Warsaw, Poland

[30] Univ Presov, Presov, Slovakia

[31] Hsch Bremen Neustadtswall, Bremen, Germany

[32] Texas Womans Univ, Denton, TX USA

[33] CQ Univ Australia, Rockhampton, Australia

[34] Tartu Hlth Care Coll, Tartu, Estonia

[35] Univ Ostrava, Ostrava, Czech Republic

[36] Univ Texas Austin, Austin, TX 78712 USA

[37] Liverpool John Moore Univ, Liverpool, Merseyside, England

[38] Dublin City Univ, Sch Nursing & Human Sci, Dublin, Ireland

[39] Inst Hlth Ageing, Bratislava, Slovakia

[40] INESC TEC, Porto, Portugal

[41] Univ Med & Pharm Carol Davila, Bucharest, Romania

[42] Hosp Univ Virgen de la Victoria Malaga, Campus Univ Teatinos, Malaga, Spain

[43] Univ Sherbrook, Sherbrooke, PQ, Canada

[44] Catholic Univ Appl Sci Mainz, Mainz, Germany

[45] Univ Coll Southeast Norway, Notodden, Norway

[46] Wroclaw Med Univ, Wroclaw, Poland

[47] Minist Hlth & Social Welf Republ Srpska, Banja Luka, Bosnia & Herceg

[48] Flinders Univ S Australia, Adelaide, SA, Australia

[49] Univ Skopje, Fac Med, Univ Childrens Hosp, Skopje, Macedonia

来源：

NURSING ETHICS | 2019年 / 26卷 / 05期

关键词：

Care left undone; missed nursing care; nursing care; rationing; resource allocation; PUBLIC MANAGEMENT; AUSTERITY; HOSPITALS; EDUCATION; ETHICS;

D O I：

10.1177/0969733018759831

中图分类号：

B82 [伦理学（道德学）];

学科分类号：

摘要：

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues - missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone - suggesting that nurses, in certain contexts, are actively engaged in rationing care - in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care - despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource.

引用

页码：1528 / 1539

页数：12

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