Effect of Health Management in Raising Awareness Rate of Disease Prevention and Treatment in Patients with Prehypertension

Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.

Healthcare Worker-Related Factors Contributing to Tuberculosis Treatment Non-Adherence among Patients in Kisumu East Sub-County

Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.

Characterization of Wastewater in School Environments for an Ecological Treatment Solution: A Case Study of Ndiebene Gandiol 1 School

The study conducted at Ndiebene Gandiol 1 school in Senegal has unveiled serious environmental and public health challenges. The wastewater analysis revealed high levels of Biochemical Oxygen Demand (BOD5), Chemical Oxygen Demand (COD), and fecal coliforms, signaling potential risks to the well-being of students and staff. This situation mirrors a wider issue in rural educational settings, where inadequate sanitation persists. Intensive wastewater treatment options are known for their effectiveness against high pollutant loads but are resource-intensive in both energy and cost. Conversely, extensive treatment systems, while requiring more land, provide a sustainable alternative by harnessing natural processes for pollutant removal. The research suggests a hybrid treatment approach could serve the school’s needs, balancing the robust capabilities of intensive methods with the ecological benefits of extensive systems. Such a solution would need to be tailored to the specific environmental, financial, and logistical context of the school, based on comprehensive feasibility studies and stakeholder engagement. This study’s findings underscore the urgency of addressing sanitation in schools, as it is intrinsically linked to the health and academic success of students. Quick, effective, and long-term strategies are vital to secure a healthier and more prosperous future for the youth. With proper implementation, the school can transform its sanitation facilities, setting a precedent for rural educational institutions in Senegal and similar contexts globally.

Effectiveness of Health Education Video in Improving Treatment Adherence among Patients with Tuberculosis: An Interventional Study from Bengaluru, India

Background: Non-adherence to tuberculosis (TB) treatment might prolong disease transmission and also increases the risk of drug resistance. Various studies have been carried out to determine the predictors of non-adherence but intervention-based studies to address treatment adherence are scarce. This study intends to estimate the treatment adherence rates following delivery of patient-centered health education videos in the intervention tuberculosis unit (TU) and to compare the treatment adherence with that in the comparison TU. Methods: An interventional study was conducted in two TUs of Bengaluru urban district among all newly diagnosed TB cases on daily regimen treatment over a period of three months from November 2017 to January 2018. A patient centered health education video was developed and shown by the treatment supporters to all eligible participants consenting to participate in the intervention TU. The video was shown once at the beginning of intensive phase treatment and once in the continuation phase of treatment. A total of 100 patients, 21 from intervention TU and 79 from comparison TU formed the study sample. Patient details were obtained from their treatment cards. Data on missed doses per month per patient were also noted. Data were entered into Microsoft excel worksheet and analyzed using statistical package for social sciences. Data are expressed as frequency and percentages. Chi-square test was applied to compare groups. Results: The majority of the study participants were aged between 25 - 44 years. Equal distribution of cases was seen among males and females. Intervention TU had significantly higher number of pulmonary TB cases. Treatment adherence rates were 90.5% and 84.8% at end of intensive phase and 85% and 71.4% at end of continuation phase in the intervention and comparison TU respectively, and this difference was not statistically significant. Conclusion: Use of mobile video-based health education showed better treatment rates and was found to improve TB treatment adherence.

Knowledge of Health Communications Management and Treatment Seeking-Behavior Regarding Malaria in Uganda

In Uganda, there is still insufficient comprehension of malaria as a lethal disease especially in rural areas despite universal bed-net distribution coverage and effective anti-malarial treatment. Aim: To get evidence-based knowledge to establish the contribution of an individuals’ knowledge from various health communications that could increase their active involvement in health care especially seeking timely appropriate treatment for malaria or suspected malaria. Method: A cross-sectional survey using a correlational design was employed on a clustered sample of 380 rural households in 05 sub-counties of Kanungu district. Data were corrected between October 2016-January 2017 using researcher-administered questionnaires, key-informant interviews and focus group discussions. Correlation analysis was done. Result: There is a significant positive relationship between knowledge of health communications and treatment-seeking behavior (r = 0.312;p ≤ 0.01). Conclusion: Exposure to consistent Behavioral Change Communications messages influences treatment-seeking behaviour. Thus, in malaria-prone communities, it appears that other factors including sufficient targeted persuasive health communication are lacking in influencing personal orientations towards treatment-seeking behaviour. Therefore, proper Health Communications management supplements efforts from other disciplines and players, against malaria in Uganda.

Access to Child Health Care, Medical Treatment of Sick Children and Childhood Mortality Relationships in Kenya

Child health care factors such as medical treatment of sick children have direct and indirect effect on childhood mortality. Through international cooperation, a number of countries including Kenya have gathered information on provision of child health services at facility level from periodic Service Provision Assessment (SPA) surveys. Kenya has also gathered information on medical treatment of sick children at household level from periodic Demographic and Health Surveys (DHS). However, establishing how health care information in the SPA surveys relates to childhood mortality and also how these factors relate to medical treatment of sick children in the DHS has been constrained by differences in sample designs of the surveys. This study deployed a fstrategy of constructing community level variables derived from the SPA survey data and incorporated them into DHS data which served as the main data source. The SPA and DHS sampling designs for Kenya allow computation of stable estimates of regional demographic and health service indicators at provincial level. This study analyzed information gathered from 690 health facilities in 2010 SPA and 6079 births born less than 60 months from 2008/09 DHS. The study found that access to child health services, waiting time before service in facility and time to the nearest referral facility were significant facilitating factors for medical treatment of sick children. The study also established that waiting time before service in facility was the only access to health care factor which had a significant effect on childhood mortality when HIV prevalence was excluded in the analysis. However, the significance of waiting time before service diminished with inclusion of HIV prevalence. Further research is required to refine definition and measurement for child health care variable on female autonomy.

Demineralized Drinking Water in Local Reverse Osmosis Water Treatment Stations and the Potential Effect on Human Health

Water is important for life and its elements are very useful for human body to some extent. Reverse Osmosis (RO) is a very effective method in minimizing the concentrations of some elements in drinking water treatment. Therefore, the goal of this study is to measure the concentrations of some important parameters for human body and the role of Reverse Osmosis (RO) method in the local drinking water treatment stations in minimizing these constituents. This goal was achieved by comparing the effluent of five local drinking water treatment stations that depends on Reverse Osmosis as a primary treatment for the water produced from the Al-Diwaniyah water treatment plant. These parameters are PH, EC, TDS, Ca, Mg, and TH. Therefore, samples were collected and tested in Al-Qadisiyah Environmental Authority for these local drinking water treatment stations for seven weeks, in order to compare the effluent with the minimum concentrations required for human body according to the health studies and guide lines. The results show that all the drinking waters produced by these stations were below the WHO and Iraq standards. The concentrations of Calcium were in the range from 5.3 to 25 mg/l, while the concentrations of magnesium were in the range from 9.5 to 18.2 mg/l. Therefore, drinking water produced from RO stations should be remineralised to increase the concentrations of necessary constituents in order to minimize the risk of the potential influence of low level concentrations containing calcium carbonate or by adding calcium compounds to the water.

Identifying Treatment and Healthcare Seeking Behavior as a Means of Early HIV/AIDS Intervention in Africa

Background: Late diagnosis of Human Immunodeficiency Virus (HIV) infection and delayed commencement of antiretroviral therapy (ART) in sub-Saharan Africa is known to contribute to high morbidity and mortality. It is therefore, prudent to develop innovative approaches to ensure early HIV diagnosis because patients with low immunity will usually develop opportunistic infections and seek some remedial action. A treatment and health care seeking behavior survey was carried out in semi-urban communities in Malaba and Busia in Kenya and Uganda to evaluate the treatment and healthcare seeking behavior among patients visiting randomly selected drugstores. Methodology: Random sampling was applied and questionnaires were used to collect information from 165 interviewees who visited drugstores seeking health information, treatment and other health related services. Results: The results indicated that among this group of people, 67% visited drugstores before any other health facility. 72.2% sought treatment for various illnesses and services ranging from headaches, body fever, gastro-intestinal disturbances, family planning pills, sexually transmitted infections and chronic medications. Among the patients interviewed, there were a number of factors that affected treatment choice. These included the distance to the facility as well as the absence of a consultation fee or fee for service. Conclusion: With proper support, drugstores can play a major role in the implementation of health interventions that seek to promote early diagnosis and treatment as well as play a pivotal role in educating the population on disease prevention and management. In Sub-Saharan Africa, drugstores can play a major role in HIV and AIDS interventions where most patients seek medical intervention for opportunistic infection.

我国儿童青少年抑郁防治进展、问题及对策

近年来,我国儿童青少年抑郁防治在心理健康干预、早期识别、诊治服务供给和保障方面取得了积极进展,但与儿童青少年抑郁防治的严峻形势相比仍有一定差距。当前,我国儿童青少年抑郁防治存在着综合防治体系尚未健全、早期识别能力薄弱且覆盖面不足、治疗存在一定风险和短板、防治专业人才缺口巨大等问题。应进一步健全儿童青少年心理健康服务体系,完善儿童青少年心理健康筛查和分级管理制度,提高儿童青少年抑郁诊疗水平和优化服务模式,多途径培养儿童青少年心理健康服务相关人才,不断提升儿童青少年抑郁防治服务的供给能力和可及性。

Patient and Health System Factors Associated with First Line Tuberculosis Treatment Adherence, 2009-2014

Background: The prevalence and incidence rate of tuberculosis remains high although the disease is known to be almost always curable provided the patient adheres to the treatment regimen. This study assessed the strength of association between known patient and health system factors associated with first line tuberculosis treatment adherence. Methods: A quantitative cross sectional study. Retrospective chart reviews were conducted among 570 persons who had primary tuberculosis and received first line treatment at a health facility within the Nkangala district, Mpumalanga province and who had a treatment outcome recorded between 1st January 2009 and 31st December 2014. Adherence to first line tuberculosis treatment was defined as taking ≥80% of tuberculosis prescribed drugs within a period of 6 to 8 months. Stata software (logistic regressions model) was used to analyze results and find the strength of association between known factors and treatment adherence. Results: Out of the 570 study participants, 473 were adherent and 96 were not adherent. There was a statistically significant association between age 18 years and above (OR: 1.02, P-value: 0.027), sex (lower in males OR: 0.44, P-value: 0.001) and support (OR: 3.04, P-value: 0.05) and HIV (OR: 1, P-value: 0.634) and first line TB treatment adherence. Conclusion and Recommendation: >80% adherence to first line tuberculosis outcome is possible. The support given to people with tuberculosis will further enhance adherence to first line tuberculosis treatment.

Drug-Treatment Generation Combinatorial Algorithm Based on Machine Learning and Statistical Methodologies

Finding out the desired drug combinations is a challenging task because of the number of different combinations that exist and the adversarial effects that may arise. In this work, we generate drug combinations over multiple stages using distance calculation metrics from supervised learning, clustering, and a statistical similarity calculation metric for deriving the optimal treatment sequences. The combination generation happens for each patient based on the characteristics (features) observed during each stage of treatment. Our approach considers not the drug-to-drug (one-to-one) effect, but rather the effect of group of drugs with another group of drugs. We evaluate the combinations using an FNN model and identify future improvement directions.

A Review of Systemic Lupus Erythematosus (SLE): Symptoms, Risk Factors, Treatment, and Health Related Quality of Life Issues

In this paper, we present a thorough review of one of the most life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.

北京市综合医改前后社区卫生服务机构治疗费用的受益人群分析

背景厘清社区卫生服务机构主要服务的人群特点,对下一步社区卫生服务机构的精准改革具有十分重要的意义。目的通过分析综合改革前后北京市社区卫生服务机构治疗费用的受益人群特征,为下一步改革政策制定和调整提供精准的数据支持。方法本研究基础数据来源于2016—2019年北京市卫生总费用核算基础数据库,其他数据来源于2016—2019年《北京市卫生健康统计年鉴》《北京市卫生财务统计年报》《北京市卫生费用核算报告》等。采用多阶段分层整群抽样的方案选取社区卫生服务机构,从HIS系统纳入全年的门诊数据、住院患者的数据。采用卫生费用核算体系2011(SHA2011)核算、分析社区卫生服务机构治疗费用的受益人群状况。结果2016—2019年北京市社区卫生服务机构治疗费用从121.81亿元增长至222.45亿元,年均增长19.07%。40岁以上中老年患者治疗费用历年占比均在92%以上,60~岁、80~岁两个年龄组患者治疗费用增长较快,年均增速分别为24.08%、25.84%;治疗费用中内分泌、营养和代谢疾病,症状、体征和检验异常、循环系统疾病占比最高,内分泌、营养和代谢疾病,神经系统疾病,症状、体征和检验异常疾病治疗费用增长较快,年均增速分别为40.11%、48.40%和32.43%。结论综合改革后分级诊疗成效初显,社区医疗服务资源主要由中老年患者、内分泌、循环系统等慢性非传染性疾病患者所消耗,改革引导更多中老年和慢性病患者流向社区,社区卫生服务机构应该从服务能力、人才队伍、慢性病管理、医联体建设等多方面着手,提升其服务能力,巩固和维持改革的效果。

广州市“十二五”与“十三五”期间利福平耐药肺结核患者发现与治疗情况分析

目的:分析广州市“十二五”与“十三五”结核病防治规划期间利福平耐药肺结核(RR-PTB)患者发现与治疗情况,为进一步制定本地区RR-PTB防治规划提供科学依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病信息管理系统”,按照登记时间导出2011年1月1日至2020年12月31日,即“十二五”(2011—2015年)和“十三五”(2016—2020年)规划期间广州市登记的肺结核患者耐药病案数据(包括性别、年龄、民族、职业、户籍、耐药类型、治疗分类等相关信息),筛选出利福平耐药患者病案,分析患者登记、人群特征、耐药筛查和治疗转归情况。结果:2011—2020年,RR-PTB患者年均登记率为0.71/10万(1152/16286.08万),从2011年的0.31/10万(42/1346.32万)上升至2015年的0.38/10万(60/1594.95万)和2020年的0.97/10万(182/1874.03万),呈逐年上升趋势(χ_(趋势)^(2)=256.395,P<0.001)。其中,“十二五”期间年均登记率为0.34/10万(250/7358.06万),不同年份登记率的差异无统计学意义(χ_(趋势)^(2)=4.674,P=0.322);“十三五”期间年均登记率为1.01/10万(902/8928.02万),不同年份登记率的差异有统计学意义(χ_(趋势)^(2)=38.439,P<0.001)。1152例患者中,以男性(851例,73.87%)、25~34岁青壮年(257例,22.31%)和家政家务及待业(364例,31.60%)为主;流动人口、初治、RR-PTB(除异烟肼耐药)、广泛耐药肺结核比例分别从“十二五”的8.80%(22/250)、11.20%(28/250)、0.00%(0/250)和0.00%(0/250)上升到“十三五”的54.43%(491/902)、37.14%(335/902)、19.84%(179/902)和0.78%(7/902),差异均有统计学意义(χ^(2)=91.370、298.740、97.915、34.096,P值均<0.001)。广州市耐药肺结核高危人群筛查率由2017年的60.91%(148/243)上升至2020年的98.95%(568/574),新发/初治病原学阳性肺结核耐药应筛查率由2018年的83.93%(1410/1680)提高到2020年的94.99%(3222/3392),差异均有统计学意义(χ_(趋势)^(2)=425.043、269.670,P值均<0.001)。纳入治疗、完成治疗和治疗成功的患者比例分别从“十二五”的81.20%(203/250)、2.46%(5/203)和45.81%(93/203)提高到“十三五”的91.02%(821/902)、33.62%(276/821)和67.48%(554/821),治疗失败患者比例从17.73%(36/203)降低至2.68%(22/821),差异均有统计学意义(χ^(2)=19.112、86.809、46.636、58.572,P值均<0.001)。结论:在“十二五”与“十三五”规划期间,广州市RR-PTB的防治工作取得了显著的成效。下一步工作中需继续坚持政府主导、多部门合作和全社会共同参与的原则,切实落实结核病防治规划要求,加强结核病防治服务体系建设。

整合型服务体系构建背景下医防融合实现机制研究

背景实现基层医防融合,创新医防协同、医防融合机制是我国医疗卫生领域在“十四五”期间的重要任务。目的分析整合型服务体系构建背景下医防融合的实现机制,为探索适应健康中国战略的医防融合路径提供参考。方法以2018年为时间节点,以“医防融合”“医防协同”“防治结合”为关键词检索中国知网和万方数据知识服务平台相关文献,筛选出对医共体、医联体等整合型服务体系案例政策措施和实施效果进行研究的文献,最终筛选出文献18篇,案例15个。基于彩虹模型,从宏观、中观、微观三个层面以及支持要素确定系统整合、组织整合、专业整合、服务整合、功能整合、规范整合为条件变量,以良好医防融合效果为结果变量,采用定性比较分析方法探索整合型服务体系构建背景下的医防融合实现机制。结果共有4条组态路径能有效提升医防融合效果,4条路径分别符合多层面整合型、中微观整合型路径,同时得出以下结果:(1)依托整合型服务体系开展医防融合更为有效,在整合型服务体系下存在多种路径可有效提升医防融合效果;(2)服务整合对提升医防融合效果起着基础保障作用;(3)对提升医防融合的系统整合、专业整合和功能整合相关政策指标设置尚不健全。结论(1)依托医联体、医共体等中国特色的整合型服务体系提升医防融合效果;(2)充分发挥服务整合的基础保障作用;(3)参考多层面整合型案例的成功经验,均衡设置宏观、中观、微观层面政策指标,同时完善系统整合、专业整合以及支持要素的整合。

综合护理干预对耐多药结核病患者心理状态及服药依从性的影响

目的:探讨心理干预和团体活动对耐多药结核病患者心理状态及治疗依从性的影响。方法:将200例患者随机分为常规组和干预组各100例,常规组采用常规健康教育及一般常规护理,干预组采用心理干预、团体活动等多形式干预,采用症状自评量表(symptom checklist-90,SCL-90)进行心理状况调查测评,采用服药依从性量表进行服药依从性测评。结果:SCL-90中躯体化、强迫症状、人际关系敏感、抑郁、偏执、精神病性、睡眠及饮食几个维度,干预组得分均低于常规组(P<0.05),干预组SCL-90情况总均分低于常规组(P<0.05);干预组患者治疗依从性总均分高于常规组(t=-2.740,P=0.007);其中“结核病治疗周期长,您是否觉得长期服药有困难?”“您多久会有一次忘记服药?”“在过去的2周内,是否曾经忘记服用结核药?”这3个条目的分值干预组均高于常规组(P<0.05)。结论:心理干预及团体活动可改善耐多药结核病患者的不良心理状态,提高治疗依从性,促进患者康复。

考试焦虑障碍临床诊疗中国专家共识

考试焦虑障碍是一组与考试等评价性刺激相关的综合征,是考试带来的较为严重的心理问题之一。长期的考试焦虑容易引起紧张、恐惧、烦躁、抑郁等负性情绪,损害个体的工作记忆、注意等认知能力,严重的甚至会导致个体出现自杀意念。为进一步规范考试焦虑障碍的临床诊疗,在中华医学会心身医学分会考试焦虑协作组的组织下,由13名专家组成专家组,包括精神科医师和心理学专家,基于国内外文献和临床诊疗经验等制定本专家共识,以期从流行病学、病因、临床表现、评估、治疗等方面为临床医生提供科学、全面的指导。

内蒙古自治区社区5类精神障碍患者精神卫生服务利用现状

目的:描述内蒙古自治区社区5类精神障碍终生患者精神卫生服务利用现况,为健康教育和制定相关政策提供参考。方法:采用分层多阶段不等概率抽样方法抽取内蒙古自治区18岁及以上常住居民共12 315名,采用复合性国际诊断交谈表调查心境障碍、焦虑障碍、物质使用障碍、间歇爆发性障碍、进食障碍等5类精神障碍及精神卫生服务利用现况,以单因素分析方法进行描述性统计。结果:5类精神障碍中,任何一种精神障碍终生患者咨询率为18.7%,治疗率为10.2%,患者接受非医务工作者治疗的比例最高(31.4%),其次是接受精神科或心理科医生治疗;患者中有1.1%的患者接受药物治疗,有2.5%的患者接受心理治疗。结论:内蒙古自治区精神障碍患者精神卫生服务利用率较低,要广泛开展正确求医的健康教育。

以家庭为中心的健康教育干预对自身免疫性疾病患儿治疗效果的影响研究

目的 探讨针对自身免疫性疾病(AD)患儿实施以家庭为中心的健康教育干预的效果。方法 选择2020年4月至2022年2月该科收治的AD患儿120例,按随机数字表法分为2组。对照组60例患儿实施常规护理,观察组60例患儿在此基础上实施以家庭为中心的健康教育,2组均随访6个月。对比2组患儿治疗依从性、家属健康认知、发病频次及家属满意度。结果 观察组患儿护理后治疗依从性评分[(5.69±1.10)分]高于对照组[(4.12±0.86)分],家属健康认知中的疾病发生原因、治疗措施及预后注意事项各方面评分[分别为(80.89±7.60)、(81.88±7.74)、(79.85±8.14)分]均高于对照组[分别为(76.74±6.78)、(77.71±7.22)、(76.15±7.64)分],出院6个月后发病频次[(3.11±0.43)次]低于对照组[(3.38±0.65)次],差异均有统计学意义(P<0.05);观察组家属满意度(95.00%)高于对照组(83.33%),差异有统计学意义(P<0.05)。结论 以家庭为中心的健康教育干预能够提升AD患儿家属健康认知及患儿治疗依从性,减少发病频次,利于预后,家属满意度较高。

医保支付方式由治病向健康转型—先期探讨研究

为系统讨论医保支付方式改革驱动由治病向健康转型的可能性和实践模式,以目标—发展重点透视矩阵作为分析框架,以慢性病为切入点,基于安徽省医共体慢性病打包支付的案例,探讨中国情境下的以健康为导向的医保支付方式改革的路径和方法。研究发现,伴随人口结构和社会需求的变化,在理念层面上,医保支付政策已体现出由治病向健康转型的态势,医保支付政策的内容、形式、载体趋向多样化。目前中国复合式医保支付框架已经建立,但改革内容和进展不平衡,尚未发挥向健康转型的激励引领作用。持续推进医保支付方式改革并对改革内容进行适应性调整,将是下一阶段工作的重点。