基于人群健康的国家医疗卫生服务系统建模设计

Model designing of population health-targeted national health delivery system

目的:揭示国家医疗卫生服务系统(health delivery system,HDS)行为特征及其促进人群健康动力机制,为国家宏观卫生决策提供理论与方法学依据。方法:依据复杂适应性系统理论(CAS),应用系统动力学建模技术与方法,构建HDS宏观模型。结果:提出我国卫生事业“高覆盖,合理水平”的发展策略,界定了基于人群健康、社区为主体的以及城乡一体化的系统目标、结构与特征,并据此构建HDS宏观模型。结论:系统动力学建模方法是揭示HDS复杂性的有效工具,据此构建的HDS复杂系统模型可有效分析并解释HDS行为特征及促进人群健康动力机制。

Objective：To reveal the behavior characteristics of health delivery system （HDS） and the dynamical mechanism by which HDS promoting population health,so as to provide theoretical and methodological evidences for the decision-making of national macro health system. Methods： The macro model of HDS was constructed by using the theory of complex system and the method of system dynamics. Results： The principle of ＂high coverage and reasonable quality＂ was put forward as developmental strategy of national health service. The improvement of population health was taken as the system objective of HDS; meanwhile, HDS was community-centered and city-country integrative. The macro model of HDS was constructed based on the above objectives. Conclusion： Modeling based on system dynamics is effective to reveal the complexity of health delivery system. The HDS complex system model constructed in this article can be used to analyze and interpret the behavior characteristics of HDS and the dynamic mechanism by which HDS promoting population health.