The welfare value of FDA's mercury-in-fish advisory: A dynamic reanalysis

Assessing the welfare impact of consumer health advisories is a thorny task. Recently, Shimshack and Ward (2010) studied how U.S. households responded to FDA's 2001 mercury-in-fish advisory. They found that the average at-risk household reduced fish consumption by 21%, resulting in a 17%-reduction in mercury exposure at the cost of a 21%-reduction in cardioprotective omega-3 fatty acids. Based on a static assessment of the health costs and benefits Shimshack and Ward concluded that the advisory policy resulted in an overall consumer welfare loss. In this note, we propose a dynamic assessment that links the long-term cardiovascular health effects of the advisory to life-cycle consumption. We find that under reasonable assumptions the welfare loss might be much larger than suggested. Our analysis highlights the importance of accounting for dynamic effects when evaluating persistent changes in exposure to environmental health risks.     

Well-being: its influence and local impact on public health

Objectives

To explore the emergence of the concept of well-being and examine its influences on the modernization of the public health structure at the local level.

Study design

The article applies a theoretical and policy orientated approach.

Methods

The article assesses the concept of well-being and applies its uses to local policy and practice.

Results

The concept of well-being has implications for the development of local public health structures, policy making and delivery.

Conclusions

In terms of local policy making, it enables public health professionals to develop locally based concepts and uses of well-being, engage communities, make links to social capital and consider wider determinants within them. In terms of delivery, it focuses attention on the need for collaboration between local statutory and voluntary organizations in applying local concepts of well-being to public health policy; and engaging with healthcare interventions grounded within local context and needs.     

The Cold Weather Plan evaluation: an example of pragmatic evidence-based policy making?

Objectives

An evaluation of the Cold Weather Plan (CWP) for England 2011–2012 was undertaken in April 2012 to generate the basis for further revisions. It is widely considered good practice to formulate and revise policy on the basis of the best available evidence. This paper examines whether the evaluation is an example of pragmatic evidence-based policy-making.

Study design

A process evaluation with a formative multimethods approach.

Methods

An electronic survey and national workshop were conducted alongside the production of a number of summary reports from the Health Protection Agency surveillance systems and Met Office meteorological data. The Department of Health and the Met Office were consulted on how the evaluation recommendations shaped the revised CWP and Met Office Cold Weather Alerting System respectively.

Results

The Cold Weather Plan survey had 442 responses, a majority from Local Authorities, and from all regions of England. Thematic analysis generated qualitative data, which along with feedback from the workshop were synthesized into six main recommendations. Reviewing the new CWP and the Met Office Cold Weather Alerting System revealed significant modifications on the basis of the evaluation.

Conclusions

The evaluation sets the context for cold weather and health during the 2011–2012 winter. This study shows that the CWP 2012–2013 was revised on the basis of the national evaluation recommendations and is an example of pragmatic evidence-based policy-making.     

政策工具视角下国内护理卫生政策的文本分析

目的 研究1978年—2020年护理卫生政策中政策工具使用情况,探讨现有政策工具的分布情况及框架结构,为后续政策的制定及落实提供参考。方法 基于Rothwell&Zegveld构建的政策工具分析框架,采用内容分析法,构建X维度（基本政策工具）及Y维度（政策发展阶段）的二维分析框架,对现有护理卫生政策文本进行编码整理和量化分析。结果 最终纳入24篇政策文件,共整理378条政策分析条目。X维度中,供给型、需求型、环境型政策工具所占比例分别为24.60%、14.02%、61.38%。Y维度中,萌芽探索期、补充完善期、成熟提升期政策工具占比分别为23.02%、31.75%、45.24%。结论 目前国内护理卫生政策工具总体使用不协调,供给型政策工具较关注人才培养,科技研究和信息化建设有待增加;需求型政策工具应用较少,缺乏有效拉动作用;环境型政策工具使用过于频繁,内部工具比例有待调整。建议可进一步把握护理卫生政策演化的规律性,提升政策实施的实效性,强化政策组合的整体性。     

我国近年药品审评审批政策文件分析

自2015年8月国务院《关于改革药品医疗器械审评审批制度的意见》(国发[2015]44号,44号文)出台以来,我国药品医疗器械审评审批制度改革持续推进。为了更好地理解我国药品审评审批制度改革,本文对我国2015年8月18日至2018年12月31日期间的相关法规政策文件进行检索、梳理、综述,以期对药品行业政策发展趋势进行浅析,对行业提供参考。     

Understanding Physicians’ and Nurses’ Adaption of National-Leading Patient Safety Culture Policy: A Qualitative Study in Tertiary and General Hospitals in Korea

BackgroundIn Korea, the safety culture is led by national policy. How the policy ensures a patient safety culture needs to be investigated. This study aimed to examine the way in which physicians and nurses regard, understand, or interpret the patient safety-related policy in the hospital setting.MethodsIn this qualitative study, we conducted four focus group interviews (FGIs) with 25 physicians and nurses from tertiary and general hospitals in South Korea. FGIs data were analyzed using thematic analysis, which was conducted in an inductive and interpretative way.ResultsThree themes were identified. The healthcare providers recognized its benefits in the forms of knowledge, information and training at least although the policy implemented by the law forcibly and temporarily. The second theme was about the interaction of the policy and the Korean context of healthcare, which makes a “turning point” in the safety culture. The final theme was about some strains and conflicts resulting from patient safety policy.ConclusionTo provide a patient safety culture, it is necessary to develop a plan to improve the voluntary participation of healthcare professionals and their commitment to safety. Hospitals should provide more resources and support for healthcare professionals.     

计量控制机制对预防误诊误治的作用

误诊误治现象是发生于医疗服务过程中的一种客观存在.随着临床诊断、治疗方法及检查手段的工程技术化,医学仪器的计量是否准确,将直接影响临床诊断的准确性及治疗的有效性.现代的临床诊断（包括物理诊断、生化诊断、影像诊断）主要是靠医疗仪器来实现的,文章引入医学计量控制机制,说明通过对医学仪器的测量控制、计量监督和计量评审的方法,检查或检验医疗器械的技术参数是否满足相应的标准、规程和技术规范的要求,对医疗仪器的可用性进行确认,从而最大限度的降低由于医疗服务工程技术化导致误诊误治的可能性.