卫生技术评估在健康保险和健康管理中的应用

卫生技术评估作为重要的卫生决策工具,能够为决策者的循证决策提供参考依据。梳理了国内外卫生技术评估的程序及内容,回顾了卫生技术评估在国内外健康保险和健康管理领域的应用现状和进展,提出了新时期背景下卫生技术评估应明晰关键角色定位、回归评估目标价值、重视患者参与、保证独立客观、合理使用大数据等发展新要求,同时针对我国卫生技术评估存在的问题,结合国际经验提出了规范设计评估流程、促进决策转化、加强多方交流、提升循证决策意识、保障评估公正透明等相关建议,为促进卫生技术评估在健康保险和健康管理中的应用提供科学依据。     

Public health and health reform in Australia

The national health reform agenda appears to have omitted public health. In this article, I outline how public health is different from primary care, and why a holistic approach to reform should include public health. The current reform agenda is very much focused on addressing the problems in acute care and the hospital system, with the focus on primary care being a means to this end. Until the health system is addressed as a whole, with all its essential components integrated and interlinked, truly successful reform of the health system, with genuine long-term vision and sustainability, will not be possible.     

健康的社会决定因素与健康的不公平

尽管过去20年在大多数国家的预期寿命一直增加,但不同人群健康状况的差异明显,健康的不平等现象越来越严重,其根源在于健康的社会决定因素.本文基于健康的社会决定因素的基本概念,从社会等级、儿童早期生活、社会歧视3个方面系统地阐述了健康的社会决定因素与健康不公平的现象以及相关的干预措施,提倡部门间的合作,为我国在健康改善方面促进多部门合作,减少健康不公平性提供了理论与实证依据.     

环境生态健康与公共卫生策略

追求健康、长寿、与环境的和谐是公共卫生的永恒主题。为此,本文就环境生态健康与医学模式的改变、生态环境的危机及桃战、建设环境生态健康的公共卫生策略进行扼要的阐述。     

Preconception health: a public health challenge

Minimal attention has been paid to preconception counseling even though good preconception health may be among the most important segments of a woman's life. Only in recent years have most healthcare providers, including obstetricians, realized that the initiation of health care and guidance after conception may be too late to prevent birth defects, low birthweight and infant mortality. The Oklahoma State Department of Health's Birth Defect Registry has developed a Women's Health Appraisal Questionnaire to assist physicians in identifying high-risk behaviors and other condition in the patient's environment that may be linked to detrimental outcomes to the fetus. The Women's Health Questionnaire can be offered to women of childbearing age in the waiting rooms of health clinics. The questionnaire takes about three to five minutes for the patient to complete. Free English and Spanish versions of the Women's Health Appraisal Questionnaire and other preconception tip booklets are being offered to physicians and health departments in Oklahoma. To order the preconception health questionnaire and booklets, there is an order form included in this journal.     

Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics

The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.     

Challenges in health and health care for Australia

The next Australian Government will confront major challenges in the funding and delivery of health care. These challenges derive from: Changes in demography and disease patterns as the population ages, and the burden of chronic illness grows; Increasing costs of medical advances and the need to ensure that there are comprehensive, efficient and transparent processes for assessing health technologies; Problems with health workforce supply and distribution; Persistent concerns about the quality and safety of health services; Uncertainty about how best to balance public and private sectors in the provision and funding of health services; Recognition that we must invest more in the health of our children; The role of urban planning in creating healthy and sustainable communities; and Understanding that achieving equity in health, especially for Indigenous Australians, requires more than just providing health care services. The search for effective and lasting solutions will require a consultative approach to deciding the nation's priority health problems and to designing the health system that will best address them; issues of bureaucratic and fiscal responsibility can then follow.     

健康教育和健康促进在社区全科医疗服务中的作用

第 13届世界健康教育大会提出 :健康教育是一门研究传播健康知识和技术、影响个体和群体行为、消除危险因素、预防疾病 ,促进健康的科学”。第 14届世界健康教育大会上又提出 :“健康教育及其相关的理论是一种崭新的科学文化 ,它的着眼点应是如何促使人们建立和形成有益于健康的行为和生活方式 ,以消除危险因素 ,更好地促进和保护人民群众的健康。”我国制定《关于卫生改革与发展的决定》也提出 :“健康教育是公民素质教育的重要内容”。以上所述都表明了健康教育既是整个卫生事业的组成部分 ,又是公民素质教育的重要内容 ,其根本着眼点是 ,…     

加强健康教育与健康促进课程建设的必要性

健康促进,包涵了个人行为改变和政府行为改变两个方面.各国已将健康教育、健康促进作为卫生保健事业发展的重要任务.在我国拟从改变领导阶层健康观入手,制定相关政策,改变医疗卫生部门的职能,形成全社会参与、各部门合作的外部环境,以确保健康促进的实践,医学院校培养的学生应具有健康促进知识和实践健康促进的能力,推动健康促进事业的发展.