RESEARCH PROPOSAL

Research Proposal

Research Proposal: The Effect of Nursing Care for Tackling Asthmatic Children in UK, Wales

Summary

What determines access to the British Children's Asthma and Allergy Centre, the most specialized health care facility for asthmatic children in UK? This publicly funded national institution is mandated to serve all segments of the population equally. The paper reports from the experiences of families with children having a confirmed diagnosis of moderate to severe asthma. (Österle, 2002, 46-49) The study population was selected from a national register of state cash-benefit recipients. Within this register, all families with a child under the age of 9 and with the diagnosis of asthma at the end of 1997 were selected (N=30). Further information about the population was gathered in a postal survey. It was found that access to the facility, measured as at least one admission during the period of the disease, was primarily determined by variations in morbidity. In particular, measures of health condition that presupposed a professional's evaluation of the child's health condition were significant. In addition, access was influenced by several factors not directly related to the need for treatment. (Österle, 2002, 46-49) It was found that families with a doctor in their social network had greater likelihood of access, and this in part accounted for the observed association between education and access. The pattern of access was also influenced by geographical factors, but not in a way that reduced the significance of educational background. Membership of, and participation in, patient organizations also increased the families' chances of receiving top-level professional treatment. The results depart from professional norms and officially stated health policy in UK, which assert that health condition is the only valid criterion for allocating scarce medical goods. (Goddard & Smith, 2001, 1149-1162)

Background & Rationale

The British welfare system is based on a high degree of universalism. Scarce and specialized medical services are to be provided to all members who need them according to their needs. All other criteria are considered as “distortions” of the distributive process. These normative foundations accord on of “complex” equality, that states that each social good has its own norms of social justice, which operate autonomously within different distributive spheres. A personal advantage in one sphere, such as a privileged education, cannot be turned to advantage in another sphere, such as better health care. (Goddard & Smith, 2001, 1149-1162) The purpose of this paper is twofold. Firstly, to assess the extent to which distributional outcomes are distorted by parents' educational background. Is it the case that scarce and highly specialized medical goods are allocated in ways that affect different social strata in different ways? Secondly, to identify generative mechanisms that can explain why such distortions occur. This strategy implies an investigation into the character of the social networks of families, but also their participation and membership in patient organizations. (Österle, 2002, 46-49)

The problem of under-utilization in the most remote regions is explicitly recognized in the institution's annual reports. There was no difference in frequency of admittance between families ...