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Svetlichnaya T. G., Tsyganova O. A., Borchaninova E.L.
Northern State Medical University, Archangelsk
Summary. Consumption of medical services as a
medical-sociological problem was studied by western sociologists during
the whole 20-th century. The study subject was development of
methodological approaches to analysis of medical services consumption.
So far, the significant research and practical experience on many
problems of medical services consumption has been accumulated: models of
behavior of healthy and sick persons have been developed, a systemic
classification of interrelations between doctors and patients has been
created, there has been organized control of medical services delivery
taking into account population satisfaction with quality of medical
services etc.
The study goal was to summarize and systematize current
methodological approaches to the study of consumption behavior at the
market of medical services and to ground expedience of their application
in practice of the Russian healthcare. In the article, results of a
comparative analysis of scientific studies on the problem of medical
services consumption have been given. Studies by 28 national and 55
foreign authors dedicated to the studied topic have been analyzed. There
has been considered the content of the main theoretical-conceptual
approaches developed by foreign researches for studying consumption
behavior at the market of healthcare services on the basis of the
structural-functional analysis of healthcare system activities by T.
Parsons. A description of the main theoretical models applied in the
studies concerning problems of production and consumption of medical
services has been given: the Health Belief Model and the Social
Behavioral Model describing sick persons behavior and their access to
medical care.
The conducted comparative analysis of methodological and methodical
approaches to studying of consumption behavior at the market of medical
services as an interdisciplinary problem has shown the necessity of use
of theoretical-conceptual constructions of medical sociology. However in
our country, there is practically no continuous systematic study of
medical services consumption behavior. As consequence of the forming
practice of theoretical grounding of methodical empiric studies, the
studies are conducted in many directions what is not reasonable. The
least understood is the effect of medical services provider’s
characteristics on volumes and kinds of consumed medical care, as well
the effects of consumers’ reference to the healthcare system. Further
conceptualization of the problem of interrelations between patients and
providers claims special scientific attention. Poorly known are the
issues of understanding influence of financial mechanisms changes in
healthcare on medical services consumption behavior as well as social
and medical effects obtained as a consequence of such influence.
Key words. Consumption of medical services; Health Belief Model; Behavioral Model.
References
- Alekseyev V.A. Vartanyan F.Ye., Shurandina I.S. Otsenka sistem
zdravookhraneniya s pozitsiy Vsemirnoy organizatsii zdravookhraneniya
[Assessment of health care systems from WHO positions]. Zdravookhraneniye 2009;(11):57-67.
- Barmina T.V. Kultura potrebleniya meditsinskikh uslug v sovremennom
rossiyskom obshchestve [Culture in health service consumption in the
present day Russian society]: [PhD. Thesis]. Volgograd; 2009. 23 p.
- Glembitskaya O.V. Farmakoekonomicheskoye obosnovaniye vybora
obuchayushchikh metodik dlya bolnykh bronkhialnoy astmoy
[Pharmacological and economical foundations for selection of training
methodics for bronchial asthma patients]: [PhD. Thesis]. Volgograd;
2009. 27 p.
- Kucherenko V.Z., Kravchenko N.A., Ragozin A.V. Krizis
zdravookhraneniya - dialektika resheniy: ot «biznesa na boleznyakh» i
«meditsinskogo kommunizma» k rentabelnoy ekonomike obshchestvennogo
zdorovya [Crisis of health care – dialectics of decisions: from
«business based on diseases» and «health communism» to efficient public
health care economy]. Ekonomika zdravookhraneniya 2010;(3):5−15.
- Makintayr R. Sotsialnaya politika v stranakh s perekhodnoy
ekonomikoy v aspekte razvitiya chelovecheskikh resursov [Social policy
in countries in transition in the aspect of human resource development].
Problemy prognozirovaniya 2002;(2):142.
- Martinson Zh.S. Istoriya, osnovnyye problemy i perspektivy
razvitiya sotsiologii meditsiny v USA [History, main problems and
prospects for development of health sociology in the USA] [PhD.
Dissertation]. Volgograd; 2006. 154 p.
- Panova L.V., Rusinova N.L. Dostup k uslugam zdravookhraneniya:
metodologicheskiye podkhody i metody izmereniya [Access to health care
service: methodological approaches and measurement methods]. Zhurnal sotsiologii i sotsialnoy antropologii 2002;(4):147−163.
- Reshetnikov A.V., Yefimenko S.A. Sotsiologiya patsiyenta [Sociology of a patient]. Moscow: Zdorovye i obshchestvo; 2008. 304 p.
- Shishkin S.V., et al. Rossiyskoye zdravookhraneniye: oplata za
nalichnyy raschet [Russian health care: payment in cash]. Nezavisimyy
institut sotsialnoy politiki. Moscow: Izdat. dom GU VShE. 2004. 248 p.
- Sheyman I. M., Shishkin S.V. Rossiyskoye zdravookhraneniye: novyye
vyzovy i novyye zadachi [Russian heath care: new challenges and new
targets]. GlavVrach 2009;(7):10-32.
- Ulumbekova G.E. Zdravookhraneniye Rossii. Chto nado delat.
Nauchnoye obosnovaniye «Strategii razvitiya zdravookhraneniya RF do 2020
goda». Kratkaya versiya [Health care of Russia. That is what should be
done. Scientific foundation of «The strategy for development of health
care in the RF up to 2020». Brief version]. Moscow: GEOTAR-Media; 2010.
96 p.
- Aday L, Cornelius LJ. Designing and conducting health surveys: a
comprehensive. 3-rd ed. San Francisco, Calif.: Jossey-Bass. 2006. 518 p.
- Andersen R. A behavioral model of families' use of health services. Chicago; 1968. 111 p.
- Baggett TP, O'Connell JJ, Singer DE, Rigotti NA. Unmet Health Care
Needs of Homeless Adults: A National Study. Am. J. of Public Health
2010;100(7):1326−1333.
- Berger SM. What your doctor didn’t learn in medical school. What you can do about it. N.Y. Morrow Cop., 1998. 336 p.
- Chen JY, Fox SA, Stockdale SE, Kagawa-Singer M, Cantrell C. Health
disparities and prevention : Racial/ethnic barriers to flu vaccinations.
J. of Community Health 2007;32(1):5−20.
- Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: An
introduction to theory and research. Reading, MA: Addison-Wesley. 1975.
578 p.
- Covey JA, Davies ADM. Are people unrealistically optimistic? It
depends how you ask them. Brit. Journal of Health Psychology
2004;(9):39−49.
- Mechanic D. Social research in health and the American
sociopolitical context: the changing fortunes of medical sociology. Soc.
Sci. Med. 1993;36(2):95-102.
- Parsons T. Social Structure and dynamic process: The case of medical practice. Social System. N.Y., 1951. 376 p.
- Pescosolido B. Illness Careers and Network Ties: A Conceptual Model
of Utilization and Compliance. Advances in Medical Sociology /G.
Albrecht and J. Levy editors. Vol. 2. Greenwich, 1991. P. 161-185.
- Pescosolido BA, Kronenfeld JJ. Health, illness, and healing in an
uncertain era: challenges from and for medical sociology. J. Health.
Soc. Behav. 1995;35:5-33.
- Phillips KA, Morrison K R, Andersen R, Aday LA. Understanding the
context of healthcare utilization: assessing environmental and
provider-related variables in the behavioral model of utilization.
Health Serv. Res. 1998;33(3):571-596.
- Rosenstock IM. Why people use health services. Milbank Mem. Fund. Q. 1966;44(3):94-127.
- Saltman RB. Patient choice and patient empowerment in northern
European health systems: a conceptual framework. Int. J. Health Serv.
1994;24(2):201-229.
- Solomonoff R, Rapoport A. Connectivity of random nets. Bul. of matematical biophisics 1951;18:107−117.
- Waitzkin HB. The politics of medical encounters: how patients and
doctors deal with social problems. New Haven: Yale University Press,
1991. 311 p.
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