关于提高卫生决策质量的我见

决策是管理工作的核心，它是现代管理中具有重要作用。卫生决策在卫生事业发展中起着关键作用。为此、必须提高决策质量。影响卫生决策质量提高的主要因素有：信息、决策目标和决策者。决策者掌握科学决策的基本程序和方法对提高决策质量至关重要。提高卫生决策质量还必须遵循系统开放原则、同步协同原则、未来预测原则、决策的科学化与民主化相结合的原则以及从实际出发，实事求是的原则。     

可持续发展与卫生决策现代化

可持续发展是人类社会发展模式的一次历史性教变。它标志人类发展进入了一个新的阶段。可持续发展的新思想、新观念、新知识从整体上转变人们的思想观念和行为规范，改变人们的思维方式。从可持续发展的角度来研究卫生领域的问题，对卫生决策的现代化有重要的促进作用，促使卫生的规范化、科学化、系统和程序化。     

卫生决策质量控制再探

随着科学管理的逐步推行，卫生决策质量的控制也提出了更高地要求。本文试图从科学管理对决策的要求、决策的不同类型和形式、卫生决策质量的控制等角度论述了卫生决策质量控制的一些问题。     

灰色区划决策在卫生管理中的应用

卫生事业管理的主要目标是提高服务质量和相应的经济效益。为此采取很多措施，这些措施或因素对管理目标会产生影响，但这些因素中有些信息不全或称为灰元，可采用灰色区划进行分析。它是以效益、差益、局势效益（或局势差益）及从局势到效益（或差益）的变换为基础进行的...     

随机决策在卫生管理研究中的应用

随机决策又称风险性方案决策,是属于不确定性的一种决策,旨在从备择风险方案中选取最好的一个方案的方法。由于存在未控制的随机因素(它具有已知的概率),它既可能发生,也可能不发生,在做决策时就要冒一定的风险。本文应用在概率条件下可望得到的“期望值”作为决策指标,以此指标大小选择最优方案。     

软科学决策与“误差”种种

由于管理活动中的管理者、被管理者和作用对象(即客观环境)经常处于动态变化之中,这就给软科学决策工作带来许多不可预知的复杂因素,以至造成一连串难以避免的各种误差(包括认识误差和行为误差),应采取的态度绝不是回避、躲闪和视而不见,而应该是敢正视、及时测出这些误差,并积极消除之。在进行正确决策之前,管理者应该及时测出以下六种误差:1、局部与整体的误差局部与整体,经常会由于各自的利害不同,而产生一些矛盾,这些矛盾,又往往导致决策者在进行分析判断时,出现一     

区域卫生规划与资源配置决策的设想

区域卫生规划和资源的合理配置能使有限的卫生资源发挥更大的效益,是卫生事业持续、稳定、协调发展和提高卫生服务综合效益、更好地满足社会对医疗卫生需要的保证,也是卫生事业管理的一项重要内容。 在计划经济条件下,卫生资源的合理配置是卫生计划工作的目标。但是,由于我国用条块分割的方式管理和使用卫生资源,政府卫生行政部门计划管理的权限     

卫生决策支持系统设计与实现

本文基于健康医疗数据资源,以提升卫生决策水平为目的,设计了覆盖公共卫生、医疗服务、基层卫生、药品管理、医疗保障等业务领域的具备信息支持、监控预警、分析评价、趋势预测、综合优化等核心功能的卫生决策支持系统,以及包含数据层、业务层、表现层的系统架构和数据仓库、模型库、方法库、知识库等决策支持库;并以医疗保障(新农合)业务的决策支持应用为例,对部分决策支持的功能进行开发应用;最后提出了构建卫生决策支持系统的建议。     

基于决策树模型的卫生应急风险评估技术研究

目的探讨运用决策树模型进行突发公共卫生事件风险评估的技术和方法。方法根据风险评估的结果将突发公共卫生事件划分为三个等级：高风险、中等风险、低风险。以某地区历史上已经发生的突发公共卫生事件为样本集,收集样本集中各个突发公共卫生事件的相关属性值及风险等级等信息,运用香农信息论中关于信息熵的理论,采取ID3算法,以各个属性为研究对象,以信息增益作为选择评价属性的衡量标准,逐层选择信息增益最大的属性作为节点（根节点或子节点）,以某一树枝子集中包含的突发公共卫生事件是否为同一等级作为判断叶节点的标准,构建基于突发公共卫生事件属性进行风险评估的卫生应急风险决策树模型。结果卫生应急风险决策树模型为突发公共卫生事件风险评估提供了评估规则,叶节点数代表了风险评估的规则数。结论卫生应急风险决策树模型能够用较少的关键属性快速、准确地判断事件的风险等级,为实施突发公共卫生事件风险的快速评估提供技术支持。     

Eligibility for long-term care in The Netherlands: development of a decision support system

In The Netherlands, eligibility for subsidised long-term care services is assessed by regional governmental assessment agencies. We examined which factors predict eligibility for eight long-term care alternatives, ranging from a variety of arrangements for care at home to admissions to residential and nursing homes. Data were drawn from the records of a sample of the regional assessment agencies, mostly during the year 2000. The model shows that not only disease and disability but also age, household composition, current housing situation, and use of health-care services determine the choice between the long-term care alternatives. On the basis of this model, we developed a decision support system. This system predicts eligibility for long-term care alternatives on the basis of applicant characteristics, and can support needs assessors in making decisions on the eligibility of individual applicants. It is used for standardization of intake processes and development of protocols for needs assessors. At the population level, it may provide information for managers and policy-makers on the distribution of demand for long-term care in the near future.     

预防医学本科生教学实习基地的建设与管理探讨

目的：总结预防医学大学本科生校外现场实习基地的自身建设与管理工作实践经验。方法：通过对实际工作回顾性阐述和分析,总结出大学本科生校外现场实习基地的自身建设与管理的最佳途径和经验。结果：承担并出色完成两所著名医学院校合计八届合格本科毕业生教学任务。结论：实习基地的自身建设与管理工作实践证明,该教学实习基地从基地建立到基地管理各环节的工作思路和经验,均取得明显成效,具有可操作性,对于指导疾控工作具有深远的实际意义。     

试论公共卫生突发事件危机处理中的科学决策

公共卫生突发事件具有突发性和难以预测性，罹及数众，严重影响社会经济秩序，其引发的危机将对社会造成严重的危害。在事件处理过程中。由于救治机会稍纵即逝，因此要求决策者在时间压力和不确定性极高的情况下，必须对其做出关键性决策。运用科学决策的方法，通过科学的思维方式和决策程序，借助各种科学的分析手段和方法，能够有效地弥补经验决策的不足，避免非理性的决策后果，提高对公共卫生突发事件的应对能力。     

Use of health impact assessment in incorporating health considerations in decision making

STUDY AIM: The aim of this project is to identify from a range of sources the factors associated with the success of a health impact assessment (HIA) in integrating health considerations into the final decision and implementation of a planned policy, programme, or project. DESIGN: Three methods were adopted: (a) a review of HIA case studies; (b) a review of commentaries, reviews and discussion papers relating to HIA and decision making; and (c) an email survey of a purposive sample of HIA academics, HIA practitioners, and policymakers. Information was captured on the following characteristics: information on the year undertaken; geopolitical level; setting; sector; HIA type; methods and techniques used; identification of assessors. MAIN RESULTS: Two groups of factors were identified relating to the decision making environment and to the technical conduct of the HIA. With regard to the environment, striking a balance between decision maker ownership and HIA credibility; organisational, statutory and policy commitment to HIA, and the provision of realistic, non-controversial recommendations were cited as enablers to the integration of HIA findings into the decision making process. Barriers included a lack of knowledge of the policymaking environment by those conducting HIA. Regarding factors relating to the conduct of the HIA: use of a consistent methodological approach; inclusion of empirical evidence on health impacts; timing of the HIA congruent with the decision making process; involvement of expert HIA assessors; and shaping of recommendations to reflect organisational priorities were cited as enablers while lack of a standardised methodology; lack of resources and use of jargon were cited as barriers. CONCLUSIONS: The findings emphasise the importance of considering the politico-administrative environment in which HIA operates. The extent to which HIA fits the requirements of organisations and decision makers may be as important as the technical methods adopted to undertake it.     

打造卫生行政公共信息平台，构建卫生综合决策支持系统

卫生行政部门的各个政务、业务信息信息系统搭建在统一的网络信息平台之上，各个应用系统之间实现统一规划，统一维护，资源共享，互联互通，消除信息孤岛。卫生行政部门各级领导可以通过一个数据中心、一个网络平台，得到各种决策数据、信息，从而可以更科学地做出指挥决策。该信息平台可以实现各种应用系统的新增、扩展，实现包括语音、视频等各种数据进行交换、查询。     

新型公共卫生教学基地建设实践与探索

通过对嘉定区新型公共卫生基地建设内容、获得效益和今后发展进行讨论,探讨了人才培养经验和基地的发展方向,为社区基层公共卫生人才培养提供经验。     

A systematic review of decision support needs of parents making child health decisions

Objective  To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child.
Context  The first step towards implementing patient decision support is to assess patients' information and decision-making needs.
Search strategy  A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched.
Inclusion criteria  Non-intervention studies containing data on decision support needs of parents making child health decisions.
Data extraction and synthesis  Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre-defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co-ordinating Centre approach.
Main results  One-hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making.