结构方程模型应用卫生政策与体系研究的系统综述

目的:分析结构方程模型在国内卫生政策与体系实证研究的现状,为进一步完善结构方程模型在卫生政策与体系研究中的应用提供参考。方法:采用系统综述方法,检索国内卫生政策与体系研究领域内结构方程模型的实证研究文献,分别从研究角度、内容和方法进行分析。结果:共筛选得到121篇文献,包括58篇学位论文和63篇期刊文献。文献分别从个人(全社会)、卫生监督管理机构、医疗卫生机构和相关企业角度,对卫生筹资与人力资源、卫生服务组织及提供、卫生治理与管理等进行实证研究。方法学应用方面,121篇文献在建模理论依据、抽样依据及方法、样本数据特点及所选参数估计方法和模型拟合评鉴各个层面水平不一,研究趋势规范化,但仍有不足。结论:现阶段结构方程模型在卫生政策与体系研究领域的应用研究涉及面广,具有实践意义,但需进一步拓展研究的深度和广度,并重视完善方法学应用的规范性。     

国内外高层次人才培养和引进政策探讨

目的 创新驱动究其本质是人才驱动,综合国力竞争归根到底是高层次人才的竞争。本文通过梳理国内外高层次人才培养和引进政策,以期为我国各地区高层次人才培养和引进政策的制定提供参考。方法 本研究主要采用文献法、政策分析法、比较借鉴法等分析美国、英国、日本等及我国高层次人才培养和引进政策的历史与现状。结果 高层次人才是领域内知识层次高、创新能力强的人才群体,也是国家重点培养对象。高层次人才的培养和引进已上升至国家战略。结论 研究认为我国在高层次人才培养和引进上存在立法层次较低、重经济激励轻科研环境打造、政策项目的 协调性待改进等问题,建议完善法律法规体系、形成高层次人才梯队政策,并加强配套政策的实施、开展政策实施效果评价。     

中国与“一带一路”沿线国家卫生合作研究及启示

目的:总结中国与"一带一路"沿线国家卫生合作研究的重点内容,为未来中国与"一带一路"国家在卫生领域的务实合作提供思路。方法:检索2013—2017年在中外文数据库公开发表的相关文献,采用文献研究法归纳总结卫生合作研究的现状。结果:通过对116篇文献研究发现,国内外学者主要关注7个方面:中医文化传播推动中医药国际合作;传染病防控需进一步加强国际机制建设;卫生服务和体制的建设要求国际经验的相互借鉴;健康产业发展前景广阔;卫生应急合作面临协调机制不足与语言障碍;对卫生发展援助的研究更加深入;关注人才培养方式。结论:现有研究主题覆盖面广,对中医药关注度最高,人才培养关注较少;强调卫生各领域的合作应加强国际经验借鉴以及政府与民间力量的共同参与;但与卫生相关的合作机制、法律法规、国际惯例和不同国家的卫生合作需求等方面的研究有待进一步的加强。     

全球开始关注卫生体系加强

在过去很长一段时间内,某一具体疾病是主要研究对象,但近几十年特别是2005年以来,许多组织开始参与全球卫生研究并关注卫生体系加强。本文对这一关注产生的原因及方式展开研究。研究采用了过程追踪的定性方法,并对政治层面引发和限制其关注的因素进行分析。研究发现加强卫生体系之所以得到广泛关注,主要是因为：全球卫生的参与者担心卫生体系方面的问题会影响千年发展目标的实现,并担心全球卫生行动可能会给国家卫生体系带来负面影响。此外,许多全球卫生组织已经意识到,薄弱的卫生体系会成为实现组织既定目标的瓶颈。尽管目前有众多的参与者支持加强卫生体系,但这些行动者还未形成有凝聚力的政策联盟。此外,加强卫生体系的概念不清晰,而且加强卫生体系的证据很薄弱。由于全球金融危机、全球卫生政策的不确定性以及一些行动者暂时性地支持等,对加强卫生体系的关注是否具有可持续性,目前尚未有定论。     

卫生政策与体系研究能力述评

在实施健康中国战略背景下,对卫生政策与体系研究的需求将持续增长。提升卫生政策与体系研究能力是产出高质量研究证据和促进科学决策的关键。国际上对卫生政策与体系研究能力的研究主要聚焦于个人、机构及环境等维度。发展中国家往往通过短期培训和学位教育培养研究力量,并试图通过薪酬待遇、评价机制改革及能力发展计划等吸引和留住高质量人才。加强卫生政策与体系研究网络建设是提高卫生政策与体系研究机构水平的重要举措。此外,包括资金支持、循证决策文化在内的支撑环境为卫生政策与体系研究能力提供了发展基础。我国卫生政策与体系研究能力的发展呈现积极态势,研究人员已具备一定规模,研究经费整体呈上升趋势,已有较为稳定的研究产出,循证决策文化也日益改善。但也应当认识到,我国卫生政策与体系研究能力仍然难以满足政策需求,也与发达国家有明显的差距,不同地区和机构之间研究能力差距明显,现有的评价机制往往忽略研究的政策应用价值,成果转化能力需要提高。     

卫生监督学科建设现况与发展研究概述

卫生监督学科建设现况研究课题概述包括研究背景和意义、研究目标和内容、研究方法和资料来源、资料质量控制和技术路线。本研究以学科和学科建设理论为指导,以学科形成的各个构成要素为框架,对卫生监督领域的科学研究情况、政策支持、专业建设、人才培养等多个方面进行梳理,以定性和定量相结合的方式了解我国卫生监督学科建设的现况,分析存在的问题,提出完善和加快卫生监督学科建设的建议。     

我国公共卫生治理研究现状、热点及展望——基于CiteSpace的图谱量化研究

目的 对我国公共卫生治理相关文献进行可视化分析，探讨公共卫生治理研究现状和热点，为该领域研究学者提供新的研究方向和决策参考。方法 检索中国知网数据库截至2022年6月31日的公共卫生治理相关文献，运用CiteSpace软件对文献发表年份、作者、机构、关键词进行图谱量化研究。结果 公共卫生治理领域发文量在2020年呈爆发式增长，核心作者已出现，发文机构主要集中在综合性高校，研究内容涉及多个学科，研究热点主要集中在疫情防控、全球治理、社区治理、健康治理、卫生治理、人工智能、协同治理等方面。结论 我国公共卫生治理研究可划分为萌芽期、探索期、成长期3个阶段，现阶段研究已上升到国家治理层面，应继续探索我国参与全球公共卫生治理的路径，健全我国公共卫生应急治理体系，加强我国公共卫生体系的协同治理研究。     

基于知识图谱的精神科医院感染研究文献的可视化分析△

目的：基于知识图谱分析精神科医院感染领域的研究现状,明确该领域的热点及前沿,为精神科医院感染管理提供新思路。方法：以CNKI、VIP、Wan Fang Data数据库收录的精神科医院感染领域相关文献为基础,采用Cite Space对发文量、地域分布、关键词进行分析。结果：精神科医院感染受到各地学者广泛关注,发文量总体呈上升趋势。研究方式多采用回顾性调查与前瞻性研究相结合的形式;研究对象偏向于具体精神病患者及医务人员;研究内容以病原菌、手卫生为主;关键词突现显示抗菌药物、品管圈、封闭病房是未来的研究方向。结论：精神科医院感染研究持续受到关注,但相关文献产量、质量并不高,需进一步推进精神科医院感染领域的研究。     

借鉴澳大利亚经验 发展我国社区卫生服务

“社区卫生服务是城镇医药卫生体制改革的一个交汇点．也是深化改革的一个突破口。”随着社会经济的迅猛发展,健康权益受到越来越多人的重视。因为卫生政策的研究直接关系到人们能否公平的获得卫生保健,所以,针对卫生政策的研究日益丰富起来。据相关文献统计．在ISI web of Seience中检索了1975—2006年在卫生政策研究文献中的18个热点领域,各卫生政策研究领域的分布情况见表1。     

卫生政策与体系研究:界定范围，辨别方法

从中低收入国家到高收入国家,卫生服务和体系研究术语的使用混乱状况普遍存在。在卫生服务研究文献和近期卫生政策与体系研究成果的基础上,本文将讨论卫生政策与体系研究方法。本文初稿在卫生政策与体系研究联盟的会议上讨论过。该联盟成立于1998年,旨在促进和支持中低收入国家的卫生政策与体系研究。本文评价卫生政策与体系研究方法,建议优先发展策略,并指出了卫生政策与体系研究所面临的挑战。     

新型冠状病毒肺炎疫情暴发对中国医学人才培养的启示

目的本文着重分析中国2019新型冠状病毒肺炎(Corona Virus Disease 2019,COVID 19)疫情暴发以来所暴露出来的临床医学、公共卫生人才培养方面的突出问题,并结合国际经验及我国相关现况,就如何加强我国医学人才培养提出解决问题的策略与建议。方法通过新闻媒体报道、发表文章以及政策文件的查询,对此次疫情暴发、传播的影响因素进行系统分析,着重指出我国临床医学、公共卫生人才培养以及队伍建设等方面存在的突出问题。结果我国临床医学生和临床医生普遍缺乏流行病学、传染病和医院感染防控等方面的系统培训;住院医师规范化培训缺乏公共卫生方面的轮转与疾病防控实践;临床医务人员自我防护意识普遍薄弱。结论需进一步完善住院医师规范化培训制度,加强医学生和临床医生的预防医学、流行病学、生物统计、传染病防控和重大疫情防控能力的培养,建立传染病防控培训与演练制度。     

信息技术的应用现状及对医药卫生信息情报工作的创新要求

进入新世纪，发展以信息技术为中心的高新技术已经成为全球经济竞争的焦点，目前，电子信息技术、计算机信息技术、网络信息技术、多媒体信息技术等已广泛应用于医药卫生的图书文献、临床、科研、预防、教学、管理和科普宣传教育等方面。同时，信息技术也对我国医药卫生信息情报工作提出了更新、更高的要求。要适应社会信息化发展的要求，医药卫生信息情报工作必须做好信息情报思想观念、管理体制和运行机制、人才队伍建设、技术手段、服务内容和模式等方面的创新工作。     

2010-2020年家庭医生及团队绩效考核指标研究进展

与欧美等发达国家不同,我国尚未形成统一的家庭医生绩效考核体系。现今涉及家庭医生、团队等人员绩效考核的研究越来越多,但归纳、总结的资料较少。本研究复习2010—2020年我国涉及家庭医生、团队等人员绩效考核指标的文献,对具体考核指标进行归纳、总结,提炼出的框架主要为从数量和质量上考核基本医疗、基本公共卫生和家庭医生签约服务的家庭医生绩效考核指标以及从团队建设、人才培养、合作能力和满意度上考核的家庭医生团队绩效考核指标,旨在为探索建立有效的个人和团队绩效考核体系提供帮助。     

Impact of federal primary health care policy in rural areas: empirical evidence from the literature.

This review examines the equity, efficiency and effectiveness of federal rural primary care policy as documented by the existing literature. The focus is on the Community Health Center and National Health Service Corps programs which have constituted the major components of the policy. The literature relating to the policy is limited in the number of studies available and in the quality of the research. The available evidence indicates that the policy is associated with an improvement in the distribution of health resources between rural and urban areas,and among rural areas.There is also partial evidence that the policy has been cost-efficient. For federally subsidized practices,the cost of delivering a similar quality of health care is shown to be up to 50 percent less in rural than in urban areas. Rural private practitioners, though, may be more cost-efficient than federally subsidized rural practitioners, at least under certain conditions which have yet to be fully delineated. Program effectiveness is the least well documented, but the literature does suggest that the policy has had a positive effect on the health status of rural populations. Substantially more research on the efficiency, and particular the effectiveness, of federal rural primary care policy is required for the development of a rational basis for the policy.     

A novel training model to address health problems in poor and underserved populations

Health disparities are increasingly common and many U.S. practitioners have informal experience working in resource-poor settings. There are, however, few graduate medical education programs that focus on health equity. A graduate medical education program in health equity was developed at Brigham and Women's Hospital based on a review of existing literature and on a survey of junior faculty who have had informal health disparities experience. The Howard Hiatt Residency in Global Health Equity and Internal Medicine was developed as a four-year program to provide intensive training in internal medicine and health disparities. Participating residents are matched with a mentor who has clinical and research experience in the field of global health. In addition to a series of didactic teaching sessions and longitudinal seminars that focus on issues of global health equity, residents take graduate level courses in epidemiology, health policy, ethics, and medical anthropology. Residents also carry out an independent research project in a geographic area that suffers from health disparities. Two residents are selected for training per year. Participating faculty are multidisciplinary and come from diverse Harvard-affiliated institutions. Graduate medical education in the United States with a focus on health equity is lacking. It is hoped that the novel training program in health equity for internal medical residents developed at Brigham and Women's Hospital can serve as a model for other teaching hospitals based in the United States.     

Towards development of professional management in Indian hospitals

Hospitals consume the largest share of government health resources, yet, until recently, they have not been a focus of health policy and research in developing countries, where the resources are in negative proportion to the demands placed on services of health care institutions, and where the possibility of resources being increased in the short run is very remote, the only hope for the increase in the effectiveness of the health care system being the effective management of hospitals. A professional administrator with multidisciplinary training would ensure the optimal use of resources. We live in the age of perfection at all levels. Hence, professional training is the basic requirement for the personnel to function effectively in a hospital. Professional training is required to be imparted by the institutions specialised in professional training. Professional management has an immense scope and a bright future market on account of the increasing demand for specialised and quality health care. Better management or lack of it will determine the future of health service. This paper focuses on development of management and the requirement for professional administrators in India.     

科研基金:政策调整对医院科研工作的影响分析

目的了解院内科研专项基金:政策调整前后对医务人员申请院外科研项目及人才培养的情况,探索其对调动医务人员科研积极性的作用,以提高医院整体科研水平。方法通过对医院2014年度至2017年度295项院内科研专项基金:资助情况进行回顾性分析,对获得基金:的项目负责人在资助期内申报的院外科研项目及工作情况进行统计分析。结果院内科研专项基金:政策调整后,资助科室的范围进一步扩大,申报院外科研项目的负责人趋于年轻化;初、中级职称科研人才获批省部级及以上项目数、资助金额以及发表论文数量显著增加,但不同层次科研人才在科技成果转化方面有待提升。结论院内科研专项基金:政策调整后提升了医院青年人才的科研能力,但在科技成果转化方面还需加强点对点管理,进一步优化专项基金:的学科资助,促进学科均衡发展。     

Diffusion of published cost-utility analyses in the field of health policy and practice

OBJECTIVES: The diffusion of cost-utility analyses (CUAs) through the medical literature was examined, documenting visible patterns and determining how they correspond with expectations about the diffusion of process innovations. METHODS: This study used 539 CUAs from a registry. It includes data elements comprising year of publication, the research center in which the study was performed, the clinical area covered by the CUA, and the specific journal. Finally, each paper was assigned to a journal type that could be one of the three categories: health services research, general medicine, or clinical specialty. RESULTS: When the average number of publications is plotted against time, the plot reveals an S-shaped curve. It appears that, whereas CUAs initially were published more frequently in general medical or health services research journals, there was a clear increase in the diffusion of CUA into subspecialty journals over time. The concentration ratio for research centers as measured by the Herfindhal-Hirschman Index decreased over time. CONCLUSIONS: The spread of CUA through the medical literature follows patterns identified for the diffusion of other new technologies and processes. Future research should focus on what impact this spread has had on the practice of medicine and formulation of health policy.     

“Enticing case study” or “celebrated anomaly”? Policy learning from the Cuban health system

Cuba is regarded as having achieved very good health outcomes for its level of economic development. It has adopted policies and programs that focus on prevention, universal access to healthcare, a strong primary care system, the integration of health in all policies, and public participation in health. It has also established a strong and accessible system of medical education and provides substantial medical aid and support to other countries. Why then, it may be asked, has the Cuban experience not had greater influence on health policies and reforms elsewhere? This article, based on a literature review and new primary sources, analyzes various factors highlighted in the policy transfer literature to explain this. It also notes other factors that have created greater awareness of Cuban health achievements in some countries and which provide a basis for learning lessons from its policies.