Ethnography of the Social Ethics of Catholic Healthcare

天主教医疗保健社会伦理的民族志

• 批准号: 6500255
• 负责人: Simon J Lee
• 金额: $ 3.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2003-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6500255
• 关键词: behavioral /social science research tag; clinical research; community health services; data collection methodology /evaluation; decision making; ethics; ethnic group; health care policy; health care service availability; health care service evaluation; health care service utilization; health economics; health services research tag; hospital analysis; hospital organization /administration; human subject; interview; low socioeconomic status; medically underserved population; morals; psychological values; religious group

This dissertation project is a multi-sited ethnographic analysis of the interplay of Catholic social ethics and healthcare provision at the fourth largest non-profit hospital system in the US. This 48-facility corporation is the flagship of Catholic healthcare but serves diverse California constituencies. The religious mission requires that the hospitals provide a preferential option for the poor and their services are intended to serve vulnerable populations. This project investigates the role of Catholic religious values in the design of healthcare policy and service delivery by administrators and other decision-makers. It explores situations of conflicting ethics and value systems between the religious system. It seeks to understand how these values are articulated and how priorities are negotiated between institutions and how policy is developed is developed to prioritize services and increase access for underserved and other vulnerable populations and balance the tensions of resource allocation, charity and cost-effectiveness. Ethnographic research methods in this 15 month project include: 1) daily participant observation in meetings and hospital practice, 2) modified life history interviews with 10-15 informants involved in ethics issues and policy design, 3) review and analysis of documents produced by the hospital system since 1997. Field sites reflect an explicit effort to work in federally recognized disproportionate share hospitals (DSH) and other facilities where services to vulnerable populations complicate operations policy and finance strategies in a changing healthcare marketplace. In a era of federal devolution of health and welfare services, this dissertation will provide insight into this policy implementation. Research results will speak to the issues of not-for-profit health and medical care, particularly to the broader social concerns underlying the concept of hospital "community benefit" activities, beyond the dollar figures of "uncompensated care" and "charity care." It is intended to provide information of interest to provider institutions, public and private policy makers concerned about the provision of health care services to low-income and other underserved and vulnerable populations. It will also inform the work of consumer groups and community partners working with faith-based organizations in health and social welfare.

本论文项目是对美国第四大非营利医院系统中天主教社会道德与医疗保健提供之间的相互作用进行的多地点人种学分析。这家拥有 48 家设施的公司是天主教医疗保健的旗舰公司，但为加州的不同选区提供服务。宗教使命要求医院为穷人提供优惠选择，其服务旨在为弱势群体服务。该项目调查天主教宗教价值观在管理者和其他决策者设计医疗保健政策和提供服务时的作用。它探讨了宗教体系之间道德和价值体系冲突的情况。它试图了解这些价值观是如何表达的，机构之间如何协商优先事项，以及如何制定政策来优先考虑服务并增加服务不足和其他弱势群体的获取机会，并平衡资源分配、慈善和成本效益的紧张关系。这个为期 15 个月的项目中的人种学研究方法包括：1）每天在会议和医院实践中进行参与观察，2）对 10-15 名参与道德问题和政策设计的知情人进行修改后的生活史访谈，3）审查和分析由自 1997 年以来一直在医院系统中使用。现场站点反映了在联邦认可的不成比例份额医院 (DSH) 和其他设施中工作的明确努力，在这些设施中，在不断变化的医疗保健市场中，为弱势群体提供的服务使运营政策和财务策略变得复杂。在联邦健康和福利服务下放的时代，本文将深入探讨这一政策的实施。研究结果将涉及非营利性健康和医疗保健问题，特别是涉及医院“社区福利”活动概念背后的更广泛的社会关注，而不仅仅是“无偿护理”和“慈善护理”的美元数字。它旨在向关注向低收入和其他服务不足和弱势群体提供医疗保健服务的提供机构、公共和私人政策制定者提供感兴趣的信息。它还将为与健康和社会福利领域的信仰组织合作的消费者团体和社区合作伙伴的工作提供信息。