论卫生管理研究与卫生政策

论卫生管理研究与卫生政策郝模，杨涛，吴桂琴，梁永忠伴随我国改革开放的进程，卫生管理科学得到了迅速发展，卫生管理专业作为医学院校普遍开设的专业，为卫生改革输送了大量的管理人才；卫生管理研究也已经被公认为一个相对独立的研究领域；卫生管理方面的杂志也从无到...     

军队卫生管理教育的思考

本对军队卫生管理教育的现状进行了分析，探讨在新世纪的新经济，新军事格局下，军队卫生管理教育所存在的问题，探索性的研究了军队卫生管理教育的新路子，提出新形势下军队卫生管理教育的合理化建设。     

职业化是卫生管理队伍建设的必由之路

卫生管理队伍是最重要的卫生资源，职业化是卫生管理人员发挥关键作用的必备条件。卫生管理队伍职业化的基本要求有：思想革命化，要求具有较高的思想觉悟，献身敬业的精神和公正廉洁的品质；知识现代化，要求具有较高的文化水平和广博的科学知识；能力专业化，要求具有较强的卫生管理专业的管理工作能力；工作专职化，要求全身心地投入到卫生管理工作中去。卫生管理队伍职业化的主要措施有：发展卫生管理学历教育，卫生管理专业毕业生应是卫生管理人员的主要来源；发展卫生管理专业继续教育开展岗位培训，进行上岗、在岗和转岗培训。     

发展卫生管理教育加强职业化卫生管理队伍建设

《中共中央、国务院关于卫生改革与发展的决定》指出：“高度重视卫生管理人才的培养，造就一批适应卫生事业发展的职业化管理队伍”。简单一句话，高屋建领，寓意深刻，内涵丰富，任务重大，真可谓卫生管理教育事业任重道远。我国卫生管理队伍建设进程缓慢，我国卫生管理教育事业发展更是步履艰难。党中央、国务院提出建设“职业化管理干部队伍”的战略思想，为加快发展卫生管理教育事业建设一支稳定的专职卫生管理队伍起了巨大的推动作用。做为卫生管理理论与实际工作者，应紧紧抓住这一发展大好时机，为卫生管理教育事业的发展和卫生管理…     

我国卫生管理教育发展的战略方针与政策措施

我国卫生管理教育发展的战略方针与政策措施毛磊（西安医科大学卫生管理系７１００６１）近年来，由于经济体制变革等各方面的原因，使卫生管理教育进入了低谷，卫生管理教育面临着许多亟待解决的问题。本文探讨在社会主义市场经济体制下，卫生管理教育发展的战略方针和政...     

日本卫生行政管理概况

卫生行政的历史沿革日本卫生行政制度始于１８７２年，以在文部省内设置医务课为标志。翌年，该课升格为医务局。１８７４年，颁布卫生行政组织、医疗管理、药品管理、公共卫生以及医学教育等归于综合法典的医学管理制度。由于当时卫生行政管理的最大任务是传染病的防治，...     

对建设高素质职业化卫生管理队伍的几点思考

从我国卫生管理队伍的实际出发，分析了建设一支高素质职业化卫生管理队伍的紧迫性、必要性、指导思想和战略目标，建议加强领导、制定规划、健全制度、完善体制、开展培训和发展卫生管理教育等对策措施。     

吉林省卫生管理队伍人力资源开发战略

截止2005年6月30日，吉林省卫生管理人员共有10746人，约占全省卫生队伍总量的6．84％。卫生管理队伍由两部分人员组成，一部分为卫生行政部门的公务员；另一部分为卫生机构的管理人员。卫生管理人员是卫生专业技术人员开发的动力，占有核心的地位，因此开发卫生管理人力资源具有非常重要的现实意义。     

关于卫生监督体制改革的若干思考

实施卫生监督体制改革是今年的中心工作之一。如何深化卫生监督体制改革，建立“精简、高效、统一”的卫生监督执法体系，是摆在各级政府和卫生行政部门面前的一项紧迫的任务。笔者结合工作实践，谈点粗浅的认识。１　卫生行政部门的职能定位１１　根据卫生部门的性质和国家赋予的管理职能，各级卫生行政部门担负着卫生行政管理和卫生监督执法两种职能。前者是指卫生行政机关在国家卫生政策指导下，运用行政方法和手段对各项专业活动实施管理；后者则指卫生行政机关依据法律、行政法规的授权，在其管辖范围内，按照法定程序，执行卫生法律…     

预防性健康体检中存在的问题及管理措施

预防性健康体检是国家卫生行政监督的主要组成部分之一，是依法实施国家卫生行政管理的手段和方式的基础，《中华人民共和国食品卫生法》、《公共场所卫生管理条例》、《化妆品卫生监督条理》及《四川省预防性健康检查管理办法》都对预防性健康体检作了明确规定。因此，预防性健康体检工作从传统的行政管理转向法制化管理的轨道，使预防性健康体检得到了强化，     

公共卫生和公共卫生突发事件

该文从理论角度阐述什么是现代公共卫生观念 ,公共卫生应在公共卫生突发事件处理中发挥什么作用和怎样发挥作用 ,希望对确定我国现代公共卫生理论体系有所启发     

Improving health equity through health care systems research

Objective

To describe health equity research priorities for health care delivery systems and delineate a research and action agenda that generates evidence-based solutions to persistent racial and ethnic inequities in health outcomes.

Data Sources and Study Setting

This project was conducted as a component of the Agency for Healthcare Research and Quality's (AHRQ) stakeholder engaged process to develop an Equity Agenda and Action Plan to guide priority setting to advance health equity. Recommendations were developed and refined based on expert input, evidence review, and stakeholder engagement. Participating stakeholders included experts from academia, health care organizations, industry, and government.

Study Design

Expert group consensus, informed by stakeholder engagement and targeted evidence review.

Data Collection/Extraction Methods

Priority themes were derived iteratively through (1) brainstorming and idea reduction, (2) targeted evidence review of candidate themes, (3) determination of preliminary themes; (4) input on preliminary themes from stakeholders attending AHRQ's 2022 Health Equity Summit; and (5) and refinement of themes based on that input. The final set of research and action recommendations was determined by authors' consensus.

Principal Findings

Health care delivery systems have contributed to racial and ethnic disparities in health care. High quality research is needed to inform health care delivery systems approaches to undo systemic barriers and inequities. We identified six priority themes for research; (1) institutional leadership, culture, and workforce; (2) data-driven, culturally tailored care; (3) health equity targeted performance incentives; (4) health equity-informed approaches to health system consolidation and access; (5) whole person care; (6) and whole community investment. We also suggest cross-cutting themes regarding research workforce and research timelines.

Conclusions

As the nation's primary health services research agency, AHRQ can advance equitable delivery of health care by funding research and disseminating evidence to help transform the organization and delivery of health care.     

The association between health risk status and health care costs among the membership of an Australian health plan

Health promotion in Australia has developed into an accepted strategy for solving public health problems and promoting the health of its citizens. However, there are few evidence-based research studies in Australia that measure health risk status or track health changes over time with defined cost outcome measures. Those individuals with more high-risk lifestyle behaviors have been associated with higher costs compared with those with low-risk behaviors. Although intuitively it was believed that the health promotion programs had a positive impact on health behaviors and consequently on health care costs, the relationship between health risk status and health care costs had yet to be tested in the Australian population. Consequently, a verification study was initiated by the Australian Health Management Group (AHMG) to confirm that those relationships between health risks and medical costs that had been published would also hold in the Australian population using Australian private health care costs as the outcome measure. Eight health risks were defined using a Health Risk Appraisal (HRA) to determine the health risk status of participants. Consistent with previous studies, low-risk participants were associated with the lowest health care costs (377 Australian dollars) compared with medium- (484 Australian dollars) or high-risk (661 Australian dollars) participants and non-participants (438 Australian dollars). If the health care costs of those at low risk were considered as the baseline costs, excess health care costs associated with excess health risks in this population were calculated at 13.5% of total expenditures. Health risk reduction and low-risk maintenance can provide important strategies for improving/maintaining the health and well-being of the membership and for potential savings in health care costs.     

论农村卫生事业的发展与卫生政治学

卫生工作具有政治性,发展卫生事业必须讲政治。一个国家整个人群的健康不是取决于单个的公民或医生,而是取决于社会制度和社会关系。只有通过政治才能改变社会制度和社会关系。解放后我国农村卫生事业取得了令国际社会赞赏的辉煌成就,根本原因在于中国共产党注重从政治的高度认识并开展农村卫生工作。市场经济条件下,我国农村卫生事业发展遇到了挫折,需要我们重新审视农村卫生与政治的关系,探索建立卫生政治学新学科,为农村卫生工作提供理论指导。     

Schools, health literacy and public health: possibilities and challenges

Health literacy is a concept that can be widely embraced by schools. Schools throughout the world contribute to the achievement of public health goals in conjunction with their educational commitments. In this paper, the interface between a school's core business of education and public health goals is identified, and examples provided in the area of nutrition demonstrating how these links can operate at school level. The structure and function of the health promoting school is described and the author proposes that there is a very close connection between the health promoting school and the enabling factors necessary in achieving health literacy. Major findings in the literature that provide evidence of good practices in school health education and promotion initiatives are described. Also, those factors that make schools effective and which facilitate learning for students are identified. There is a substantial overlap between the successful components of a health promoting school and effective schools. This enables schools to potentially achieve all three levels of health literacy, including level 3-critical health literacy. However, there are three challenges that must be addressed to enable schools to achieve this level: the traditional structure and function of schools, teachers practices and skills, and time and resources. Strategies are proposed to address all three areas and to reduce the impediments to achieving the goals of health literacy and public health using the school as a setting.     

循证公共卫生与国境口岸卫生检疫

目的探索循证公共卫生在国境口岸卫生检疫中应用的必要性和可行性。方法通过对循证公共卫生的发展历程及其在国境口岸卫生检疫中的需求分析,从循证保健医学、循证检验医学、循证免疫规划、循证公共卫生与突发公共卫生事件四领域进行实践和措施的分析研究。结果循证公共卫生将为我国国境口岸卫生检疫决策、技术方法与科学研究提供良好的理论与实践保障,探索符合我国国情的国境口岸卫生检疫循证公共卫生研究势在必行。结论国境口岸卫生检疫应积极采用循证公共卫生理念及方法应对新形势下的机遇与挑战。     

Understanding population health terminology

Population health is a relatively new term, with no agreement about whether it refers to a concept of health or a field of study of health determinants. There is debate, sometimes heated, about whether population health and public health are identical or different. Discussions of population health involve many terms, such as outcomes, disparities, determinants, and risk factors, which may be used imprecisely, particularly across different disciplines, such as medicine, epidemiology, economics, and sociology. Nonetheless, thinking and communicating clearly about population health concepts are essential for public and private policymakers to improve the population's health and reduce disparities. This article defines and discusses many of the terms and concepts characterizing this emerging field.     

妊娠期妇女的口腔卫生预防保健

目的 调查妊娠期妇女的口腔健康状况及口腔健康教育状况.方法 对500例孕妇患龋率、牙周病及自我保健意识进行调查分析.结果 妊娠期龋齿及牙龈炎患病率分别为49.67%和75.68%, 软垢及牙石发生率分别为86.87%和52.41%,而龋齿和牙龈炎就诊率仅为3.38%,92.32%的孕妇未接受过口腔健康教育.结论 缺乏口腔保健意识和不良口腔卫生习惯是影响孕妇口腔健康状况的主要原因.     

Progressive segmented health insurance: Colombian health reform and access to health services

Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal.     

“新医改”应致力于公众健康管理

医药卫生体制改革已进入＂深水区＂,在取得一定成果的基础上更应该看到慢性病＂井喷＂、人口老龄化加速等亟待解决的问题,以此入手,合理配置医疗卫生资源、转变卫生服务模式、调整卫生服务重心来保障公众健康,通过走中国特色的健康管理之路来实现人人享有基本医疗卫生服务的目标。