Evidence-based disparities: examining the gap between health expectations and experiences.
BACKGROUND
In a time of economic austerity, one of the most daunting questions is who decides on healthcare rationing? In the current study, we sought to examine if the public can in fact provide meaningful information regarding healthcare policy issues. Based on theories of public policy, this paper tries to find out if patients behave akin to 'responsible citizens' and can provide differentiated expectations between three healthcare dimensions.


METHODS
One thousand two-hundred eleven individuals participated in a telephone interview. Participants were asked two series of questions, one regarding their views on the primary care, prevention and promotion practices they experience with their healthcare provider and one regarding the importance of these practices to them. We calculated a difference score representing the gap in each healthcare dimension.


RESULTS
In all three healthcare dimensions, the mean gap is in the positive side of the axis indicating that the public does not receive what it expects to receive, or in policy terms there is 'a responsiveness deficit'. The mean gap in relation to primary care is significantly lower than the mean gap in both preventive care and health promotion.


CONCLUSIONS
The public can provide meaningful information even in areas of endless demand and can provide an addition point of view to be considered by policy makers in complicated healthcare rationing decisions.
LecturerSenior Lecturer, Division of Public Administration and Policy, School of political Sciences, University of Haifa, Haifa, Israel.
Dana R
DR
Vashdi
Yair
Y
Zalmanovitch
D000328:Adult; D003657:Decision Making; D005260:Female; D015276:Health Care Rationing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D007557:Israel; D008297:Male; D008875:Middle Aged; D057766:Policy; D011314:Preventive Health Services; D011320:Primary Health Care; D012959:Socioeconomic Factors