Justice in Health Care Decision-Making: Patients’ Appraisals of Health Care Providers and Health Plan Representatives

Abstract

This study describes the development of two versions of a Health Care Justice Inventory (HCJI). One version focuses on patients' interactions with their providers (HCJI-P) and the other focuses on patients' interactions with the representatives of their health plans (HCJI-HP). Each version of the HCJI assesses patients' appraisals of their interactions (with either their Provider or representatives of their Health Plan) along three common dimensions of procedural justice: Trust, Impartiality, and Participation. Both the Provider and Health Plan scales assess indices that are relatively independent of patients' demographic characteristics. In addition, patients' appraisals of their interactions with their provider were only moderately related to their appraisals of their interactions with representatives of their health plan, indicating that the Provider and Health Plan scales tap distinct aspects of patients' overall experience with the health care system. Overall, procedural justice dimensions were significantly related to patient satisfaction in both the Provider and the Health Plan contexts. As predicted, procedural justice factors were more strongly tied to patient satisfaction in the provider than in the Health Plan context, and health care decisions based on distributive justice principles of Need (rather than Equity or Equality) were most closely tied to patient satisfaction in both contexts.

State Laws on Emergency Holds for Mental Health Stabilization

“…Similar knowledge gaps concern the required procedures and the rights of individuals subject to a hold. Available research suggests that if individuals believe they have been treated fairly and given a voice, their satisfaction and willingness to adhere to treatment may be enhanced (17)(18)(19), but the comparative effect on public safety is largely unexplored.…”

Using Patient Evaluations to Empirically Assess Medicaid Programs for Social Justice

“…This paper seeks to compare Medicaid patients' evaluations of their inpatient acute care with the evaluations of private-pay patients. Only one other study has used patients' appraisals to evaluate social justice in healthcare: Fondacaro et al (2005) employed similar core constructs and items as in our instrument (e.g., involvement in decision making, behaviors of nurses and doctors). Their ''Health Care Justice Inventory'' focused on three common dimensions of procedural justice: trust, impartiality, and participation.…”

Healthcare sustainability and the challenges of innovation to biopharmaceuticals in Canada

“…[52] According to Fondacaro et al, "one of the most intriguing findings in the social justice literature is that people seem to care as much or more about how they are treated in the course of decision making (procedural justice) as they do about the decision outcome (distributive justice)." [53] Therefore, for government policy makers who are faced with decisions about whether to reimburse drugs within the confines of limited resources a goal should be fairness. Furthermore, a study conducted by Murphy-Berman et al, found that individuals who felt that they were treated fairly, with regards to treatment decisions, had decreased levels of anger, and increased levels of pride.…”

“…It is thought that trust and satisfaction in health plans "can help providers who must increasingly make treatment decisions in the context of limited resources." [53] A legitimate and fair process is characterized by inclusiveness, transparency, and responsiveness. A fair process would include stakeholders in the deliberative process i.e., patients, public, and industry [51].…”