贵在“不停往前走”

新闻报道总是具有选择性，习惯凸显“刺激点”，很难真正做到全景呈现某一事件的全部细节，这是媒体共同的遗憾和无奈。尤其是碰到内容丰富的题材，而又受篇幅所限，取舍就更为艰难。曲靖医改报道，便是如此。     

Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands

The increasing demand for healthcare and the resulting pressure on available budgets render priority setting inevitable. If societies aim to improve health and distribute health(care) fairly, equity-efficiency trade-offs are necessary. In the Netherlands, proportional shortfall (PS) was introduced to quantify necessity of care, allowing a direct equity-efficiency trade-off. This study describes the history and application of PS in the Netherlands and examines the theoretical and empirical support for PS as well as its current role in healthcare decision making. We reviewed the international literature on PS from 2001 onwards, along with publicly accessible meeting reports from the Dutch appraisal committee, Adviescommissie Pakket (ACP), from 2013 to 2016. Our results indicate that there is support for the decision model in which necessity is quantified and incremental cost-effectiveness ratios are evaluated against associated monetary reference values. The model enables a uniform framework for priority setting across all healthcare sectors. Although consensus about the application of PS has not yet been reached and alternative ways to quantify necessity were found in ACP reports, PS has increasingly been applied in decision making since 2015. However, empirical support for PS is limited and it may insufficiently reflect societal preferences regarding age and reducing lifetime-health inequalities. Hence, further investigation into refining PS—or exploration of another approach—appears warranted for operationalising the equity-efficiency trade-off.     

大连医改变阵前行

学医的林青(化名)大学毕业时被分到了企业医院，后来颇费一番周折才进入大连的一家属于事业单位性质的医院。“每两年涨一次工资，而且收入跟职称挂钩。”对她这样的本科毕业生来说当然很合适了。专业对口，业务能力又强，林青在新单位很快就成为骨干。但是时间一天天过去，她发现情形开始起变化了，社会上出现了许多私营性质的     

Healthcare reform: moving forward

One of the toughest and most important issues facing America today is healthcare reform. To examine this issue more closely, four industry observers were invited to share their thoughts with Healthcare Executive.     

Patient advocacy and arthritis: moving forward

Patient advocacy is based on the premise that people have the right to make their own choices about their health care. Personal advocacy is centred on the experiential expertise of the individual affected by the condition, whereas group advocacy is grounded on patient-centred strategies and actions. The first patient advocacy groups for arthritis were set up over 20 years ago in the USA and have subsequently spread to many other countries. This paper discusses the growth and impact of personal advocacy as well as recent developments in group advocacy in the Asia-Pacific region, Europe, and North America, in terms of arthritis awareness, research, corporate partnerships, and the Bone and Joint Decade global initiative.