区域卫生信息资源规划研究

区域卫生规划被当今国际社会公认为发展医疗卫生事业的先进思想和科学管理模式,而实施信息资源规划是区域科学合理发展的基础,进行区域卫生信息资源规划是借助信息技术落实我国新医改的新型、有力手段.文章从卫生信息资源及信息资源规划的概念出发,从微观视角定义区域卫生信息资源规划概念,概括了其公益性、专用性、不平衡性、小信道及低噪声性及非对称性5个特质,对社区医疗信息资源体、综合医院为中心的信息资源体、区域影像资源体、区域卫生数据资源体及区域医疗协同资源体5个规划模式进行比较分析,最后归纳出规划的4个关键节点:现状评估及分析是规划的基础步骤、将卫生信息标准化作为规划的一项基础工作常态化、规划既要符合一般信息资源规划的规律,又要兼顾卫生领域的特色以及采用有前瞻性的理念做指导.

Abstract：

Regional health planning is a leading and scientific management philosophy for healthcare development in the international community.Information resources planning paves the way for scientific development.In the ongoing health reform in China,planning of regional health resources will play a key role by leveraging information technology.From the viewpoints of health information resources and information resources planning,the paper defines the concept of regional health information resources planning in microcosmic perspective.It summarized the five features of public welfare,specificity,imbalance,small channel and low noise,and non-symmetry.Authors compared the five planning modes,namely the community medical information resources mode,the general hospitals as the center of information resource mode,the regional PACS mode,the regional health data resource mode,and the regional medical coordination resources mode.In the paper,the planning is rounded up as four key points,that is,the basic steps of situation assessment and analysis,routine work of health information standardization,the planning should both comply with general rules of information resource planning and characteristics of the health sector,in addition to guidelines of forward-looking concepts.     

上海市医院战略规划管理的实践探索

文章在阐述医院实施战略规划管理的意义和分析国内医院实施战略规划管理现状的基础上,着重介绍了上海市23家三级医院制定"十一五"发展规划、实施战略规划管理的主要做法;归纳总结了引导公益性、提高可操作性和强调服务3方面的特点;以及在提高服务质量和患者满意度、发挥资源优势、提高运行效率、增强可持续发展能力等方面所取得的初步成效.

Abstract：

The paper described the significance of strategic planning and management for hospitals and analyzed the presence practice of such strategic planning and management in the country. It focused on the practices of 23 tertiary hospitals in Shanghai in making and implementing their development plan for the "12th Five-year Plan"; summarized their three characteristics in public benefic guidance, better operability and better services. In addition, it introduced the initial achievements made in enhancing service quality and patient satisfaction, tapping resource potentials, enhancing operation efficiency and sustainable development.     

When It Strikes,Are We Ready?Lessons Identified at the 7th Planetary Defense Conference in Preparing for a Near-Earth Object Impact Scenario

Near-Earth object(NEO)impact is one of the examples of high impact and low probability(HILP)event,same as the Covid-19 pandemic the world faces since the beginning of 2020.The 7 th Planetary Defense Conference held by the International Academy of Astronautics(IAA)in April 2021 included an exercise on a hypothetical NEO impact event,allowing the planetary defense community to discuss potential responses.Over the span of the 4-day conference this exercise connected disaster response and management professionals to participate in a series of panels,providing feedback and perspective on the unfolding crisis scenario.The hypothetical but realistic asteroid threat scenario illustrated how such a short-warning threat might evolve.The scenario utilized during the conference indicates a need to prepare now for what might come in the future,because even with advance notice,preparation time might be minimal.This scenario chose Europe for the impact,which may likely cope with such a disaster,through the Union Civil Protection Mechanism(UCPM)and other solidarity and support mechanisms within the European Union(EU),as well as with potential support from international partners.This short article raises concern about other areas in the world on how they may access NEO impact information and cope with such disasters.It also provides an idea on vast scale of such disaster vis-a-vis the current capacity of response systems to cope with a larger event in Europe or elsewhere.This scenario showed that planetary defense is a global endeavor.Constant engagement of the planetary defense and disaster response communities is essential in order to keep the world safe from potential disasters caused by NEO impacts.     

366名门诊就医者卫生知识需求调查改进护理服务模式

To understand the present condition of outpatients‘ needs for health knowledge, and revise the process of nursing services in clinic. Methods Using questionnaire to survey outpatients going to this clinic. Divide patients into groups by their age, occupation, and culture level. Statistics and X^2 test were performed by PEMS 3.0 software. Results ①The groups of higher educated level and 20-41 years old go to clinic to take health checkup.Their self-aware of health care is worse due to intense working. It is needed to strengthen health propaganda and education to them. ②The groups of yotmg people and higher educated level have some communication technique. Medicine professionals need to elevate their communication technique to the groups of elderly and lower educated level. ③The groups of 61 and over and lower educated level know less about modem medicine and classfying of departments, professionals should help them to choice departments and guide blind choice to directed choice. ④All groups need guide to read medicine manuals. Conclusion Needs investigation has provided the foundation for reform. Revising process and establishing new model of nursing services in clinic make the service range expanded, as well as the market business has succeeded.     

The Sendai Framework for Disaster Risk Reduction: Renewing the Global Commitment to People's Resilience,Health,and Well-being

The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations' post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction(UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction(WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people's mental and physicalhealth, resilience, and well-being higher up the disaster risk reduction(DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme.     

Standard

After collecting the necessary information and samples, the person responsible for industrial hygiene refers to various standards, such as the Maximum Allowable Concentrations or Threshold Limit Values, to guide him in making a professional judgement as to whether a hazard to health exists. There are many different names for the standard, ILO in its Encyclopedia of Occupational Safety and Health adopt "Exposure Limit"; however, WHO introduces another term "Health-Based Limit", but this has a different meaning. A few definitions concerning the industrial exposure limits will illustrate of these differences.     

Bangkok to Sendai and Beyond: Implications for Disaster Risk Reduction in Asia

The recently concluded World Conference on Disaster Risk Reduction(WCDRR) in Sendai, Japan and the Sendai Framework for Disaster Risk Reduction2015–2030(SFDRR) have set renewed priorities for disaster risk reduction(DRR) for the next 15 years. Due to Asia's high exposure to natural hazards, the implications of the new SFDRR have major significance for the future development of the region. The 6th Asian Ministerial Conference on Disaster Risk Reduction(AMCDRR), held in Bangkok in 2014, was a regional preparatory meeting for the WCDRR, and proposed various targets and indicators for DRR in Asia. The AMCDRR recommended inclusion of these goals in the SFDRR. This study focuses on the WCDRR negotiations, particularly outcomes that affect four major groups: local authorities; children and youth;science and technology; and business and industry. An analysis is undertaken of the overlaps and gaps in the outcomes of the 6th AMCDRR and other preceding conferences that fed into the WCDRR. A set of recommendations has evolved from this examination for consideration at the upcoming 7th AMCDRR in 2016. The areas that merit consideration in the upcoming AMCDRR2016 are:(1) development of baseline data and quantitative indicators for monitoring progress in DRR;(2) creation of a common stakeholder platform;(3) construction of city typologies for consideration in all future local level planning;(4) promotion of a culture of safety by linking large enterprises with small and medium enterprises; and(5) exchange and sharing of information and databases between regions at all scales.     

世界卫生组织健康调查资料的结构方程模型

Objective Based on the 2002 WHO health survey data, to explore the latent relationship among self-reported health level, the actual level of health, the social demographic characteristics and the risk factors, and to analyze the influence of the various surveillence indicators on self-reported health and the degree that the self-reported health explained the actual level of health.Methods Field tests for various components of the World health survey were conducted in nine countries during 2002, including India, Brazil, Burkina, Hungary, Nepal, Russia, Spain, Tunisia, and Vietnam (29 971 ).The survey questionnaire included a self-assessment component and anchoring vignette component.The self-assessment component data was adjusted and eliminated the affect of "cut-point bias" by using the anchoring vignette component data,and then was used to build the structural equation model on the relationship among selfreported health level, actual health level, social demographic characteristics and the risk factors.Results In the final structural equation model, "the actual level of health" = 0.80 × "the self-reported health level" +( - 0.04) × "the social demographic characteristics" + ( - 0.08 ) × "the risk factors" ( R2 = 0.66 ), and"the self-reported health level" = ( -0.70) × "the social demographic characteristics" +0.10 × "the risk factors" (R2 = 0.55 ).The standardized total effect of self-reported health to the actual level of health was 0.80 ,and that of the social demographic characteristics to the self-reported health and the actual level of health were - 0.70 and - 0.60, respectively.And the 16 items of self-reported health consisted of8 dimensions; and sorted by the power of impact to the actual health level, they were mobility, pain and discomfort, sleep, cognition, feelings, self-care ability, visual capacity and interpersonal activities.Conclusion There were significant linear correlation relationship between the actual level of health and the self-reported health, as well as between the self-reported health and the social demographic characteristics.And the self-reported 16 items used by the 2002 WHO health survey played an important role in the health evaluation of population.     

世界卫生组织健康调查资料的结构方程模型

Objective Based on the 2002 WHO health survey data, to explore the latent relationship among self-reported health level, the actual level of health, the social demographic characteristics and the risk factors, and to analyze the influence of the various surveillence indicators on self-reported health and the degree that the self-reported health explained the actual level of health.Methods Field tests for various components of the World health survey were conducted in nine countries during 2002, including India, Brazil, Burkina, Hungary, Nepal, Russia, Spain, Tunisia, and Vietnam (29 971 ).The survey questionnaire included a self-assessment component and anchoring vignette component.The self-assessment component data was adjusted and eliminated the affect of "cut-point bias" by using the anchoring vignette component data,and then was used to build the structural equation model on the relationship among selfreported health level, actual health level, social demographic characteristics and the risk factors.Results In the final structural equation model, "the actual level of health" = 0.80 × "the self-reported health level" +( - 0.04) × "the social demographic characteristics" + ( - 0.08 ) × "the risk factors" ( R2 = 0.66 ), and"the self-reported health level" = ( -0.70) × "the social demographic characteristics" +0.10 × "the risk factors" (R2 = 0.55 ).The standardized total effect of self-reported health to the actual level of health was 0.80 ,and that of the social demographic characteristics to the self-reported health and the actual level of health were - 0.70 and - 0.60, respectively.And the 16 items of self-reported health consisted of8 dimensions; and sorted by the power of impact to the actual health level, they were mobility, pain and discomfort, sleep, cognition, feelings, self-care ability, visual capacity and interpersonal activities.Conclusion There were significant linear correlation relationship between the actual level of health and the self-reported health, as well as between the self-reported health and the social demographic characteristics.And the self-reported 16 items used by the 2002 WHO health survey played an important role in the health evaluation of population.     

基于可及性视角的我国医药卫生资源区域分布差异研究

目的 通过对我国医药卫生资源区域空间分布的研究,以期为政府优化配置卫生资源提供政策依据.方法 将我国划分为3大经济和地理区域,选取6类医药卫生资源指标,依据2009年国家公布的31个省区的相关统计数据,应用变异系数、基尼系数、泰尔指数评价我国医药卫生资源区域空间分布的差异性.结果 每万人口生物制药企业拥有量区域间的分布差异最大,而医疗机构床位数的配置分布差异相对最小.生物制药企业和三级医院万人口拥有量的区域间极差排在前2位.东部地区是6项资源在3大地理区域间或区域内的差异贡献的最大者,经济相对落后地区是形成执业(助理)医师、床位、三级医院和药品生产企业分布区域内差异的主要贡献者,而经济发达地区对地区政府人均医疗卫生支出和生物制药企业区域间分布差异的贡献最大.总体上,经济发展水平高的地区,其人口资源拥有率也相对更高.但是,两者之间并不完全呈正比关系.结论 6类资源在我国区域间的分布均未表现出"相对合理"的状态.为更好地满足地区人群的卫生需求,政府应加大对经济不发达的西部地区生物制药产业和三级医院建设的投入,提高经济发达地区资源的有效利用和防止低水平重复建设,持续关注人均医药卫生的支出比例和执业医师的数量与质量.

Abstract：

Objective Analyzing the regional distribution discrepancy of medical and health resources in China,with the purpose of providing the government with policy making evidences for optimizing medical and health resource allocation.Results Dividing China into three regions based on regional economic development and geographic setting,and selecting 6 indicators for medical and health resources.On the basis of the statistics of 31 provinces released by the state in 2009,analyzing the interprovincial disparities of the distribution of these six resources,by means of the coefficient of variation,Gini coefficient and Theil index.Methods The largest inter-regional allocation disparity is found in the number of biopharmaceutical manufacturing companies per ten thousand population.And the smallest discrepancy is found in the number of hospital beds among these regions.The top two extreme differences of resource possession per ten thousand population between the maximum and the minmum region are the number of biopharmaceutical manufacturing companies and tertiary hospitals.The eastern region is the largest contributor to the discrepancy of allocation for the six resources within and between regions.The less developed regions contribute the most inter-regional discrepancy for the allocation of medical practitioners(their assistants included),hospital beds,tertiary hospitals and pharmaceutical companies.And the developed regions contribute the most inter-regional discrepancy of medical finance support from local governments and the most of the allocation of biopharmaceutical manufacturing companies.In general,regions of higher development enjoy greater possession of the SIX resources per population in such regions. But these two are not always in direct proportion. Condnsion Regional distribution disparity of the six resources is not yet"reasonable" in China.To better meet the health needs of the population in various regions,the government is expected to increase its financial support for building biopharmaceutical manufacturing companies and tertiary hospitals in the less developed western regions,to better use resources of developed regions,and to keep off investments at low level and repetition.The government is also recommended to pay attention to the proportion of government health finance output and the quality and quantity of medical practitioners.     

City and regional planning: a primer for public health officials

Recognizing that planners' decisions affect the public's health, some public health officials are becoming more involved in city and regional planning. This article describes city and regional planning fundamentals to help public health practitioners better understand plan making and plan implementation, including the development project review process; provides examples of how three local public health agencies are currently involved in planning; and discusses general strategies for such participation. With this information, public health officials could increase their influence on local planning with consequent public health benefits.     

Using data to plan public health programs: experience from state cancer prevention and control programs.

In 1989 the National Cancer Institute funded the second round of Data-Based Intervention Research (DBIR) cooperative agreements with state health agencies to implement a four-phase cancer prevention and control planning model that would establish ongoing cancer prevention and control programs. Activities included identifying and analyzing relevant data to develop a state cancer control plan. The authors reviewed the data analysis and planning activities of five DBIR projects to understand: how states use different types of available data to make public health planning decisions, in what ways available data were sufficient or insufficient for this planning, and perceived costs and benefits of a data-based planning approach. Many of the sources of and ways in which health statistics and behavioral data were used were consistent across states. Sources and use of data on the availability and utilization of health services and on cancer control policies were less consistent. Data were most useful in making decisions to address specific cancers, to target populations or regions, to identify general barriers, and to influence policy makers and the public. Data were less influential in identifying specific barriers within target populations and determining what proven intervention components should be implemented and how. The process of pulling this information together and involving working groups and coalitions was considered very beneficial in establishing the credibility of the state health agency in addressing the state''s cancer problem. This process relied on a national infrastructure that provided financial resources, sources of data, and research results.     

基于IRP方法的疾病登记管理应用系统设计

本文探讨如何在信息资源规划指导下,通过现况分析、业务架构、数据架构、应用架构,进行疾病登记管理信息规划,并在该规划基础上,进行基于疾病预防控制信息平台的疾病登记管理应用系统设计,为疾病登记管理提供标准化信息技术支撑,优化业务管理,提高管理绩效。     

嘉定区区域卫生信息化管理思考

本文以当前国内外卫生领域计算机网络管理的现状为背景,对嘉定区实施区域卫生信息计算机管理系统的特殊性作了具体分析。卫生领域信息化项目与政府整体信息项目,业务流程管理和行政管理,业务系统和质量控制系统的三个整合是实现区域信息化的实施关键。通过这一研究,揭示实施区域卫生信息计算机管理系统的必要性,以促进本区医疗卫生事业的进一步发展。     

Business planning in Hong Kong hospitals: the emergence of a seamless health care management process.

This paper examines the progress made by public hospitals in Hong Kong in implementing a business planning approach. A review of available literature suggests two main exploratory themes. The first establishes the key features of business planning in the private sector. The second theme discusses the problems of adapting this approach to the distinctive requirements of the public sector. The literature also suggests three dimensions for evaluating planning: incremental-developmental; reactive-proactive; ends-means. Qualitative data were collected by scrutinizing relevant organizational documentation and by discussions with focus groups formed by participants in the planning process. The data were analyzed against eight key elements of a business plan identified from the literature and from panels of business experts. These elements were found to be present in the Hospital Authority's plans but were less evident in hospital level plans. Because of the unitary nature of hospital organization in Hong Kong, it has been difficult for hospitals to break out of a reactive, incremental and ends-based pattern to a more imaginative identification of the distinctive business and market that they may be in. This is, however, changing rapidly and it is clear that there is in place a robust and 'seamless' health care management process.     

以电子病历为核心的区域双向转诊系统研究简

随着国家医疗卫生体制改革的不断推进,区域双向转诊对于医疗资源的合理调配与流动将发挥重要作用。本文以电子病历为核心,利用UML构建了双向转诊的业务流程,依托HL7国际标准对双向转诊业务进行了模型映射,实现对区域双向转诊的流程管理以及患者医疗信息的管理。     

面向集团医院的信息化规划研究——以同济医院为例

随着我国各地对医疗资源的有效利用越来越关注,各地医疗事业的不断发展,组建医疗集团、医联体已经成为促进各地医疗机构发展的有效途径,实现优势互补、资源共享和互惠互利,不仅可以促进医院的发展,也可以为患者的就医带来极大的便利。医院信息化作为医院管理重要的途径,因此面向集团化医院的信息系统成为新时期的医院信息系统规划的重要方向。本文按照集团医院的实际需求,将集团医院的信息化体系从网络规划和信息系统体系两个方面进行规划,对于网络可通过光纤网络实现内部业务网络;对于信息系统,规划了集团层面的信息系统和院区层面的信息系统,通过集团层面的信息实现院区之间的信息交互和业务协同,可实现不同类型的集团医院的管理需求。通过本文的规划,可以为集团医院的信息化建设提供有效的依据。     

山东省医疗资源配置标准测算方法研究概述

《中共中央、国务院关于卫生改革与发展的决定》明确提出了制定和实施区域卫生规划的要求，并把它列为卫生改革的重大举措之一。这对于提高政府对卫生事业发展的宏观调控能力和水平，统筹规划和合理配置卫生资源具有深远意义。该重点介绍了山东省在确定医疗资源配置标准时利用供方资料建立的测算方法，包括概念界定、具体测算方法与讨论三部分。     

Perspectives. Developing quality assurance standards for health promotion practice in the UK

The application of quality assurance principles from the wider health care field to health promotion practice has until recently been underdeveloped in the UK. A project to develop a framework for quality assurance in health promotion practice in England is described. An extensive consultation process identified six key functions of health promotion: strategic planning; programme management; monitoring and evaluation; education and training; resources and information; and advice and consultancy. Model standards and criteria were drawn up for each key function, together with guidance on implementation processes. The relationship between this quality assurance process and other approaches to accreditation of health promotion activity in settings is considered. Current implementation needs identified by practitioners include training on quality assurance, and dissemination of research findings on the effectiveness of health promotion interventions.