The Role of the National Rural Health Alliance

ABSTRACT: This paper outlines the history and subsequent development of the National Rural Health Alliance. The mission statement and objectives of the Alliance are presented. An outline of the role and function of the Alliance both now and in the future is given. Details are given of the rural associations who are members of this national rural body and key players in rural health in Australia.     

The National Conference of Rural Health Training Units

ABSTRACT: Following the establishment of Rural Health Training Units in most States and the Faculty of Rural Medicine (RACGP), a National Conference of Rural Health Training Units was held on 11 and 12 December 1992, at Moe. Primary focus of the conference was on vocational training for rural general practice, with a secondary focus on development of a multidisciplinary approach in Rural Health Training Unit curricula. It was very much a business meeting in which those actively involved in development and implementation of rural practice training came together and worked through a range of important issues. Recommendations from the conference cover the roles and responsibilities of Rural Health Training Units, curricula and accreditation of rural general practice training, and the importance of adopting a multidisciplinary teamwork approach in developing training programs. The conference recommended formation of a National Association of Rural Health Training Units, which subsequently held its inaugural meeting at the National Rural Health Conference at Armidale in February 1993.     

新医改背景下委属委管医院绩效评价体系研究

目的建立国家卫生计生委委属、委管医院绩效评价指标体系。方法通过文献查询梳理医院绩效评价指标、理论研究并设计结构化访谈提纲,对专家进行结构化访谈,设计问卷进行专家咨询。结果根据新医改要求并结合国家卫生计生委委属委管医院职能定位,初步制定了评价指标体系。结论指标体系的建立应充分考虑研究对象、本阶段政府的引导方向以及指标的内涵。     

Conducting the National Lesbian Health Care Survey: First of Its Kind

The authors of the National Lesbian Health Care Survey (NLHCS) describe the process, challenges, and experiences in planning and conducting the first and largest lesbian health survey, which helped define lesbian health and mental health issues. Challenges include lack of funding, lack of awareness that sexual orientation may affect access to care and health outcomes, sexism, homophobia, fear of AIDS, and lack of guidelines for conducting survey research with lesbians. The methodology was designed to reach a broad range of lesbians throughout the United States, including low-income lesbians, nonurban lesbians, lesbians of color, and lesbians with less formal education. Planning the survey took several years and helped frame how lesbians conceptualize health. Planning began in the late 1970s and data were collected during the fall of 1984 and spring of 1985, at a time when AIDS was emerging as a major focus for community services, research, and funding, and this is reflected in the history of conducting the survey. The process of questionnaire distribution and data collection made broad use of lesbian networks throughout the country, creating for respondents a sense of participation in a larger movement with special significance for lesbians. The National Lesbian Health Care Survey resulted in demographic, health, mental health, and community life experiences from 1925 lesbians from all 50 U.S. states and several territories, and is still the most extensive study of lesbians published to date.     

The Relationship between Health Behavior and General Health Status: Based on 2011 Korea National Health and Nutrition Examination Survey

Objectives

The aim of the present study is to investigate the relationship between health behavior and general health status.

Methods

We used data from the 2011 Korea National Health and Nutrition Examination Survey. Mental health was measured by stress recognition and depression. Dietary habit was measured by mixed grain diet. Life pattern was measured by sleeping time and working pattern. Physical activity was measured by walking and exercise. We defined general health status as Euro Quality of Life-5 Dimension (EQ-5D_index), Euro Quality of Life Visual Analogue Scale (EQ-5D_vas), number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations.

Results

Mental health, dietary habit, life pattern, and physical activity have seven factors. Most of the factors have a significant correlation with EQ-5D_index, EQ-5D_vas, number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations.

Conclusion

Health behavior and general health status have a positive correlation.     

重庆农村基层医疗卫生机构开展老年人健康管理的现状及对策初探--以沙坪坝区为例

目的：了解农村地区基层医疗卫生机构老年人健康管理的开展情况、面临的挑战,以提出改善对策。方法采用分层抽样法选取研究地点,运用专题小组讨论(FGD)进行资料收集。结果在重庆市沙坪坝区的两个农村社区组织了8组(共48人)由老年居民参加的 FGD。结果表明,农村老年居民的健康状况令人担忧,特别是老年女性;老年人健康素养较差,对健康管理的需求较大。农村老年人健康管理工作还存在以下问题：居民对老年人健康管理认识不到位,基层医疗卫生机构开展老年人健康管理的能力不足、效果不佳等。结论为了达到老年人健康管理的预期效果,需要强化“大卫生观”和多部门协作意识、加大宣传力度、创新健康教育方式、狠抓基层医疗卫生机构能力建设。     

The Health Services Research Workforce: Current Stock

Objective. To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. Data Sources. (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Study Design. Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the “core” versus related disciplines and to investigate the extent to which the “core” researchers publish, present, or participate in disciplinary venues. Principal Findings. The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self‐identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. Conclusions. The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security.     

农村卫生人力可及性探讨

强基层作为我国医改的一个重要原则,目的是为了增强基层医疗卫生机构服务能力,而增加农村医疗卫生领域人力资源的可及性是强基层的重要策略,对实现卫生服务均等化具有重要意义。从薪酬、教育培训、政策支持等方面分析影响我国卫生人力可及性的因素,探讨相应的改进农村适宜卫生人力短缺的策略,以满足农村医疗保健的需求。     

农村卫生人力可及性探讨

强基层作为我国医改的一个重要原则,目的是为了增强基层医疗卫生机构服务能力,而增加农村医疗卫生领域人力资源的可及性是强基层的重要策略,对实现卫生服务均等化具有重要意义。从薪酬、教育培训、政策支持等方面分析影响我国卫生人力可及性的因素,探讨相应的改进农村适宜卫生人力短缺的策略,以满足农村医疗保健的需求。     

农村老年人健康相关生命质量的效度评价

目的：评价农村老年人健康相关生命质量评定量表（ＨＲＬＱＳ）的效度；方法：使用ＨＲＬＱＳ对成都市龙泉镇２４５２名６０岁以上的农村老年进行了访谈调查；结果：以Ｔｏｒｒａｎｃｅ健康状态分类系统（ＨＣＳ）为标准，ＨＲＬＱＳ具有较好的准则效度。因子分析产生的７个因子也与ＨＲＬＱＳ的理论结构相一致，且各因子独立。健康自评差者ＨＲＬＱＳ总分及各维度分值也低，说明其有关联效度。ＨＲＬＱＳ能明显鉴别出有无慢性病、是     

促进卫生体制改革 加强农村卫生事业

文章采用社会调查的方法,分析了四川省农村卫生发展的现状与特点,阐明了其自然环境、社会经济文化与人口流动性对农村卫生发展带来的影响,揭示出卫生服务供需关系、卫生资源布局、卫生投入渠道、农村医疗保障筹资与补偿等方面的结构性矛盾,由此提出解决这些问题与矛盾的政策建议。     

加强农村卫生建设 改变安徽滞后面貌

安徽是一个农业大省，卫生事业发展既取得巨大成就，也尚有不尽人意之处：与兄弟省、市、自治区相比，多项卫生指标水平低下，发展滞后；政府投入不足，卫生资源匮乏，农村卫生条件较差。当前卫生改革和科技发展的新形势是一场严峻的挑战。根据国力和省情，提出发展农村卫生事业的战略思路和主要对策，以改变卫生工作滞后面貌。     

黑龙江省新型农村合作医疗卫生服务需求与利用

目的了解黑龙江省农村新型合作医疗农村居民卫生服务需要及利用状况,为进一步完善新型农村合作医疗提供依据。方法对黑龙江省2 430户共9 740名农村居民进行问卷进行调查,采用SAS 8.1软件进行数据整理和分析。结果调查地区农村居民2周总患病率为13.53%(1 317/9 740),2周患病率在不同调查县和年龄组农村居民中差异有统计学意义(P<0.05);不同县农村居民2周患病就诊率差异有统计学意义(P<0.05),2周患病未就诊主要原因为经济困难、没钱;应住院而未住院比例为79.22%(2 157/2 723),差异有统计学意义(P<0.05),农村居民应住院而未住院在不同县、家庭年收入、家庭是否有存款之间差异均有统计学意义(P<0.05)。结论黑龙江省新型农村合作医疗卫生服务需求与门诊就诊利用状况好于全国水平,但农村住院服务利用较低,农村住院服务利用与农村居民经济状况有关。     

The National Health Plan 2030: Its Purpose and Directions of Development

The National Health Plan 2030 (HP2030) started to be prepared in 2017 and was completed and announced in December 2020. This study presents an overview of how it was established, the major changes in policies, its purpose, and future directions. This study analyzed the steps taken in the past 4 years to establish HP2030 and reviewed major issues at the international and governmental levels based on an evaluation of HP2020 and its content. HP2030 establishes 6 divisions and 28 topic areas, and it will continue to expand investments in health with a total budget of 2.5 trillion Korean won. It also established goals to enhance health equity for the first time, with the goal of calculating healthy life expectancy in a way that reflects the circumstances of Korea and reducing the gap in income and healthy life expectancy between regions. The establishment of HP2030 is significant in that it constitutes a sustainable long-term plan with sufficient preparation, contains policy measures that everyone participates in and makes together, and works towards improvements in universal health standards and health equity. With the announcement of HP2030, which includes goals and directions of the national health policy for the next 10 years, it will be necessary to further strengthen collaboration with relevant ministries, local governments, and agencies in various fields to concretize support for prevention-centered health management as a national task and to develop a health-friendly environment that considers health in all policy areas.     

UNRESOLVED HEALTHCARE ISSUES IN RURAL AND REMOTE AUSTRALIA: PRELIMINARY FINDINGS FROM A NATIONAL RURAL HEALTH UNIT SURVEY

ABSTRACT: A preliminary analysis of a survey answered by 317 health practitioners with interests in heath in rural and remote Australia is described. The most important unresolved issues in rural health were service delivery problems, difficulties experienced with attracting and retaining staff, continuing education, Aboriginal health and shortage of finance.     

The World Health Organization and Global Health Governance: post-1990

This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades.     

The Role of Interorganizational Partnerships in Health Services Provision Among Rural,Suburban, and Urban Local Health Departments

Context: With limited resources and increased public health challenges facing the US, the Centers for Disease Control and Prevention and others have identified partnerships between local health departments (LHDs) and nongovernmental organizations (NGOs) as critical to the public health system. LHDs utilize financial, human, and informational resources and develop partnerships with local NGOs to provide public health services. Purpose: Our study had 2 primary goals: (1) compare resources and partnerships characterizing rural, suburban, and urban LHDs, and (2) determine whether partnerships play a mediating role between LHD resources and the services LHDs provide. Methods: We conducted secondary data analysis using the National Association of County and City Health Officials 2005 Profile Study. We used chi-squared and analysis of variance (ANOVA) to examine differences between rural, suburban, and urban LHDs. We used regression-based mediation methods to test whether partnerships mediated the relationship between resources and service provision. Findings: We found significant differences between LHDs. Urban LHDs serve larger jurisdictions, have larger budgets and more staff, cultivate more partnerships with local NGOs, and provide more health services than suburban or rural LHDs. We found that partnerships were a partial mediator between resources and service provision. In playing a mediating role, partnerships reduce differences in service provision between rural, suburban, and urban LHDs. Conclusions: Partnerships mediate the relationship between resources and service provision in LHDs. LHDs could place more emphasis on cultivating relationships with local NGOs in order to increase service provision. This strategy may be especially useful for rural LHDs facing limited resources and numerous health disparities.     

农村健康社区的构建：困境与对策

健康社区是一个包括健康人群、健康环境和健康社会有机结合的整体。建设农村健康社区对于促进农村社会和谐,实现农村公共卫生和基本医疗服务均等化,提升农村社区居民的健康保障水平具有重大的现实意义。目前,构建农村健康社区遭遇一系列困境。针对这些困境进行分析,尝试性地提出走出困境的对策。