药品福利管理试点实施现状及利益相关方的态度分析——以安徽省芜湖市为例

目的:了解安徽省芜湖市药品福利管理(Pharmacy Benefit Management, PBM)试点的开展现状、运作方式、利益相关方对PBM的态度、PBM实施的初步效果及存在问题,为PBM在我国的发展提供实证经验。方法:本文定性资料来源于关键人物深度访谈及重点流程观察,定量资料来源于机构统计报表,采用主题框架法结合描述性分析对PBM模式进行探讨。结果:试点地区PBM模式主要在社区卫生服务中心开展。开展后,药品种类增加,门诊量提高一倍,广受参与患者好评,一定程度上慢病患者回流基层并推进了基本公共卫生服务的开展。但利益相关方对其态度不一,其发展受多种因素的影响。结论:PBM能够提升基层药品可及性,在一定程度上促进慢病管理和医药分开,但其长期效果还需要更多的随访研究。     

What determines health? To where should we shift resources? : Attitudes towards the determinants of health among multiple stakeholder groups in Prince Edward Island, Canada

The population health perspective has become significant in academic and policy discourse. The purpose of this paper is to assess its significance among health care practitioners and administrators as well as the general public. Respondents in Prince Edward Island, Canada were asked to rank the broad determinants of health and comment on to where resources should be shifted to improve the health of the population. Important variations are noted between the groups with family physicians and front-line staff being similar in perceptions to the general public on most determinants than other groups. The paper concludes with discussion on the relevance of the findings for population health research and health policy.     

Integration of stakeholder engagement from development to dissemination in genomic medicine research: Approaches and outcomes from the CSER Consortium

PurposeThere is a critical need for genomic medicine research that reflects and benefits socioeconomically and ancestrally diverse populations. However, disparities in research populations persist, highlighting that traditional study designs and materials may be insufficient or inaccessible to all groups. New approaches can be gained through collaborations with patient/community stakeholders. Although some benefits of stakeholder engagement are recognized, routine incorporation into the design and implementation of genomics research has yet to be realized.MethodsThe National Institutes of Health–funded Clinical Sequencing Evidence-Generating Research (CSER) consortium required stakeholder engagement as a dedicated project component. Each CSER project planned and carried out stakeholder engagement activities with differing goals and expected outcomes. Examples were curated from each project to highlight engagement strategies and outcomes throughout the research lifecycle from development through dissemination.ResultsProjects tailored strategies to individual study needs, logistical constraints, and other challenges. Lessons learned include starting early with engagement efforts across project stakeholder groups and planned flexibility to enable adaptations throughout the project lifecycle.ConclusionEach CSER project used more than 1 approach to engage with relevant stakeholders, resulting in numerous adaptations and tremendous value added throughout the full research lifecycle. Incorporation of community stakeholder insight improves the outcomes and relevance of genomic medicine research.     

概念图在证据转化与应用项目中的研究进展

如何识别利益相关者观点一直是证据转化与临床应用的重要议题,概念图为解决利益相关者相关研究问题提供了框架。该文介绍了概念图的概念、实施步骤及其在证据转化与应用项目中的应用方向,包括明确研究问题和需求,探索证据实施的障碍和促进因素,选择和剪裁实施策略,开发概念框架和测量工具等方面,总结了概念图的应用前景,以期促进概念图在国内证据转化研究中的应用。     

中医药核心指标集研究利益相关群体选择实施要点＊

核心指标集是通过一系列规范的研制过程，形成某种疾病所有相关临床研究必须报告的、统一的、标准化的最小指标集合。确定哪些指标为核心结局指标，需要经过不同利益相关群体层层筛选并最终达成共识决定。相关利益群体的代表性，决定了核心指标集的系统性和合理性。因此，在核心指标集研制过程中利益相关群体的选择至关重要。本文对中医药核心指标集研制中利益相关群体的种类选择、样本量、参与环节、权重分配以及患者代表群的特殊性等相关要点进行归纳总结，以期为中医药核心指标集研究的开展提供方法学借鉴。     

The views of people with a lived experience of deafness and the general public regarding genetic testing for deafness in the reproductive setting: A systematic review

PurposeGenes associated with nonsyndromic hearing loss are commonly included in reproductive carrier screening panels, which are now routinely offered in preconception and prenatal care in many countries. However, there is debate whether hearing loss should be considered a medical condition appropriate for screening. This systematic review assessed research on opinions of those with a lived experience of deafness and the general public regarding genetic testing for deafness in the reproductive setting.MethodsSearch of 5 online databases yielded 423 articles, 20 of which met inclusion criteria. We assessed the quality of each study, extracted data, and performed thematic analysis on qualitative studies.ResultsMost studies indicated interest in the use of prenatal diagnosis for deafness. However, there were mixed views, and sometimes strongly held views, expressed regarding the reproductive options that should be available to those with an increased chance of having a child with deafness. Studies were small, from a limited number of countries, and most were too old to include views regarding preimplantation genetic testing.ConclusionThere is a broad range of views regarding the use of reproductive options for deafness. Further research is essential to explore the benefits and harms of including nonsyndromic hearing loss genes in carrier screening.     

Participación pública en los proyectos de investigación: formas de crear conocimiento colectivo en salud

Public participation in research projects is an emerging area in Spain and Latin American countries. There are five types of projects according to the degree of involvement that the participants have in the processes: contributory, collaborative, co-created, contractual and independent. In order to promote public participation in health research teams, their practices and competencies need to be redefined. To this end, it may be useful to ask questions in the different phases of the research, as well as to develop strategies that include audiences that have fewer channels of participation in favour of favouring equity in health. This way of doing science allows gathering experience and expertise prioritizing and adapting the research to the needs of the population, which increases its transforming capacity and the social impact of its results.     

我国药品流通领域改革政策研究评述——基于利益相关者博弈视角

药品流通领域改革是我国"三医联动"改革的关键环节。改革政策的制定、推行必然导致利益再分配。因此,从各利益主体博弈的视角对其进行评价,是全面理解改革过程中出现的非预期结果,从而科学决策政策走向,确保改革顺利推进的有效手段。本文通过梳理新医改以来药品流通领域改革政策及其研究文献,揭示现有研究存在的问题和不足,论证基于科学理论框架下的政策评价是判断改革目标是否实现的有力工具。将利益相关者理论和博弈理论引入药品流通领域进行政策评价,能够将复杂的影响因素在其理论框架下科学量化,从而揭示政策效果的因果机制,对药品流通领域改革政策有更清晰的解读和总结,为下一步政策走向提供科学合理的参考。     

社区卫生服务药品政策实施的利益相关者分析

本文通过分析社区卫生服务药品管理政策实施过程中涉及的利益相关者(集团),研究和讨论各利益相关者(集团)的角色、优势和劣势、实施意愿、实施能力及对策,总结和归纳社区卫生服务机构药品政策实施过程中存在的问题,并提出当前需要合理确定和应用基本药物目录,制定和落实有效的补偿政策,同时提高企业生产基本药品的积极性,加强宣传以提高居民对药品管理政策的认识。