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This study commenced in September 2003 with funding from the Health Research Council, and built on earlier research on elective services and pathways to surgery. Its aim was to explore clinical decision making processes. Research questions included: How do doctors determine access to elective surgery and other explicitly rationed services? How are such decisions justified in the conversations and interaction between doctor and patient? How are they rationalised into clinical criteria? The project data set includes 75 videotapes of naturally occurring interaction in general practice and surgical consultations, and has been analysed using a range of qualitative techniques, including discourse and conversation analysis. The insights gained have informed the training of health practitioners and the development of guidelines to improve existing processes for determining access to rationed health services.


  • NZ Health Research Council
  • Wellington Faculty Bequest Fund


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