Background:Despite great medical advances and scientific progress over the past century,one billion people globally still lack access to basic health care services.In the context of the 2030 Agenda for Sustainable Dev...Background:Despite great medical advances and scientific progress over the past century,one billion people globally still lack access to basic health care services.In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap,address equity and create social value.This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries.Main text:The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact.Effective partnerships,strong engagement with and endorsement by governments and communities,regulations,trust and sometimes willingness are key factors to enhance system integration,replication and dissemination of the models.Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link,integrate and synergize their efforts.Key challenges that they encountered,and lessons learnt are highlighted.Multilateral organizations and governments increasingly engage in promoting and supporting the development,testing and dissemination of social innovations to address the health care delivery gap.They play an important role in creating an enabling environment.This includes promoting the concept of social innovation in health care delivery,spreading social innovation approach and lessons learnt,fostering partnerships and leveraging resources,convening communities,health system actors and various stakeholders to work together across disciplines and sectors,and nurturing capacity in countries.Conclusions:Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish.In supporting and disseminating social innovation approach,multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.展开更多
The primary health care system(PHCS)is the portal and basis for the national health delivery system.There are a number of elements which comprise the PHCS,but the system cannot be established and developed without the...The primary health care system(PHCS)is the portal and basis for the national health delivery system.There are a number of elements which comprise the PHCS,but the system cannot be established and developed without the support of“three essential elements,”including general practitioners(GPs),health insurance,and government health investment.Through comparative analysis of the“three essential elements”of the PHCS between California in the US and Guangdong in China,this article indicates that there are three important aspects in developing a PHCS in China,as follows:training qualified GPs;establishing a diversified health insurance system to strengthen the policy connections between health insurance and the PHCS thereby increasing government health investment;and broadening health financing channels.展开更多
The concept of autonomic regulation （aR） reflects the relevance of the function of different autonomic systems for health, aR can be captured by questionnaires. We differentiate between a trait or constitutional aR ...The concept of autonomic regulation （aR） reflects the relevance of the function of different autonomic systems for health, aR can be captured by questionnaires. We differentiate between a trait or constitutional aR questionnaire version including 12 （short-version） or 18 items, respectively, with three subscales （orthostatic-circulatory, rest/activity and digestive regulation）, and an 18-item state aR questionnaire on the preceding week with four subscales （rest/activity, orthostatic-circulatory, thermo- and digestive regulation）. The validated questionnaires show satisfying to good reliability and robust validity with clear construct validity. In this article, we summarized the actually available literature on aR and the use of aR questionnaires in clinical and observational studies. We described the relationship of high aR with health and in case of low aR or loss of regulation with disease and functional disorder in the three （four） different subscales and functional systems, such as rest/activity, orthostatic-circulatory or digestive regulation （thermoregulation） with the consecutive therapeutJc need. Finally, we gave perspectives of its further application in clinical research.展开更多
目的 探讨基于自我调节常识模型(The Common-Sense Model of Self-Regulation,CSM)的中青年冠心病经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后患者干预方案的设计、实施方法及效果。方法 选取2021年7月—2022年7月...目的 探讨基于自我调节常识模型(The Common-Sense Model of Self-Regulation,CSM)的中青年冠心病经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后患者干预方案的设计、实施方法及效果。方法 选取2021年7月—2022年7月收治的中青年PCI术后患者112例作为研究对象,其中2021年7月—2021年12月入院的57例患者为对照组,2022年1月—7月入院的55例患者为试验组。试验组根据CSM在认知阶段、应答阶段、评估阶段、行为及疾病结局阶段对PCI术后患者的自我管理、疾病感知及心理进行干预;对照组采取PCI术后常规护理。比较两组干预前、干预3个月后的自我管理行为、疾病感知、焦虑评分。结果 干预3个月后,试验组冠心病自我管理行为得分高于对照组(t=6.221,P<0.001);疾病感知得分、焦虑得分均低于对照组(t=3.284,6.949;P<0.05)。结论 基于CSM的干预可提高中青年冠心病PCI术后患者自我管理能力,降低负性疾病感知及负性情绪,减轻患者身心负担。展开更多
The national health system （NHS） complexity increase requires a review of the managerial human resources evaluation and recruiting methods, considering that nowadays doctors need to improve not just their clinical c...The national health system （NHS） complexity increase requires a review of the managerial human resources evaluation and recruiting methods, considering that nowadays doctors need to improve not just their clinical capabilities, but also managerial competences. At this end it is important to develop performances control models and to identify appropriate results indicators, with the aim of introducing an effective doctors selection system for managerial roles. The paper considers the Italian situation and tests the current evaluation and selection methods, by analysing the literature and the existing legislation and by interviewing experts. Moreover, in order to reach an innovative model, complex organizations have been taken into account as benchmarks. Three different categories of experts have been interviewed and texted： national health care organizations managers, companies managers, and business consultants. The 137 interviewed experts have been asked about four main questions concerning the evaluation for hiring managers as chief medical director, department director, and head of complex units. The conducted research suggests four different options in order to evaluate and to select heads of complex unit for the most strategic roles. By consequence, the analysis shows that required characteristics must be managerial attitudes as well as clinical capabilities.展开更多
Introduction： Physicians want to know how they care for their patients. However, it can be challenging to describe the quality of their work. A basic question to ask would be： How do I care for my patients with a ce...Introduction： Physicians want to know how they care for their patients. However, it can be challenging to describe the quality of their work. A basic question to ask would be： How do I care for my patients with a certain health condition？ The authors wanted to find out whether they can answer this question for their patients suffering from osteoporosis with the support of their EHR （electronic health record）. Materials and methods： Postmenopausal women having experienced a fracture were identified from the EHR. At the same time, criteria to assess the quality of care were defined following current guidelines. As it emerged that the EHR was unsuitable to fulfill the authors＇ purpose, the free software package ＂Epi Info 7＂ was used to create a template for data entry and analysis. Results： Of the 41 female patients identified with possible osteoporotic fractures, as many as 90% （37 patients） did not have any bone-density measurements recorded despite 39% （16 patients） had been given a diagnosis of osteoporosis. Of the 16 patients with recorded osteoporosis, only two were prescribed antiosteoporotic medication. The EHR was largely inadequate to answer the question. Conclusion： ＂How do I care for mypatients with...？＂ is a difficult question to answer when relying on conventional EHR. The resulting answer is worrying and opens up a lot of room for improvement on behalf of the EHR and the quality of care provided.展开更多
基金The Social Innovation in Health Initiative received financial support from TDR.
文摘Background:Despite great medical advances and scientific progress over the past century,one billion people globally still lack access to basic health care services.In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap,address equity and create social value.This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries.Main text:The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact.Effective partnerships,strong engagement with and endorsement by governments and communities,regulations,trust and sometimes willingness are key factors to enhance system integration,replication and dissemination of the models.Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link,integrate and synergize their efforts.Key challenges that they encountered,and lessons learnt are highlighted.Multilateral organizations and governments increasingly engage in promoting and supporting the development,testing and dissemination of social innovations to address the health care delivery gap.They play an important role in creating an enabling environment.This includes promoting the concept of social innovation in health care delivery,spreading social innovation approach and lessons learnt,fostering partnerships and leveraging resources,convening communities,health system actors and various stakeholders to work together across disciplines and sectors,and nurturing capacity in countries.Conclusions:Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish.In supporting and disseminating social innovation approach,multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.
文摘The primary health care system(PHCS)is the portal and basis for the national health delivery system.There are a number of elements which comprise the PHCS,but the system cannot be established and developed without the support of“three essential elements,”including general practitioners(GPs),health insurance,and government health investment.Through comparative analysis of the“three essential elements”of the PHCS between California in the US and Guangdong in China,this article indicates that there are three important aspects in developing a PHCS in China,as follows:training qualified GPs;establishing a diversified health insurance system to strengthen the policy connections between health insurance and the PHCS thereby increasing government health investment;and broadening health financing channels.
基金financial support by Humanus InstituteBerneburg foundationGyllenberg foundation
文摘The concept of autonomic regulation （aR） reflects the relevance of the function of different autonomic systems for health, aR can be captured by questionnaires. We differentiate between a trait or constitutional aR questionnaire version including 12 （short-version） or 18 items, respectively, with three subscales （orthostatic-circulatory, rest/activity and digestive regulation）, and an 18-item state aR questionnaire on the preceding week with four subscales （rest/activity, orthostatic-circulatory, thermo- and digestive regulation）. The validated questionnaires show satisfying to good reliability and robust validity with clear construct validity. In this article, we summarized the actually available literature on aR and the use of aR questionnaires in clinical and observational studies. We described the relationship of high aR with health and in case of low aR or loss of regulation with disease and functional disorder in the three （four） different subscales and functional systems, such as rest/activity, orthostatic-circulatory or digestive regulation （thermoregulation） with the consecutive therapeutJc need. Finally, we gave perspectives of its further application in clinical research.
文摘The national health system （NHS） complexity increase requires a review of the managerial human resources evaluation and recruiting methods, considering that nowadays doctors need to improve not just their clinical capabilities, but also managerial competences. At this end it is important to develop performances control models and to identify appropriate results indicators, with the aim of introducing an effective doctors selection system for managerial roles. The paper considers the Italian situation and tests the current evaluation and selection methods, by analysing the literature and the existing legislation and by interviewing experts. Moreover, in order to reach an innovative model, complex organizations have been taken into account as benchmarks. Three different categories of experts have been interviewed and texted： national health care organizations managers, companies managers, and business consultants. The 137 interviewed experts have been asked about four main questions concerning the evaluation for hiring managers as chief medical director, department director, and head of complex units. The conducted research suggests four different options in order to evaluate and to select heads of complex unit for the most strategic roles. By consequence, the analysis shows that required characteristics must be managerial attitudes as well as clinical capabilities.
文摘Introduction： Physicians want to know how they care for their patients. However, it can be challenging to describe the quality of their work. A basic question to ask would be： How do I care for my patients with a certain health condition？ The authors wanted to find out whether they can answer this question for their patients suffering from osteoporosis with the support of their EHR （electronic health record）. Materials and methods： Postmenopausal women having experienced a fracture were identified from the EHR. At the same time, criteria to assess the quality of care were defined following current guidelines. As it emerged that the EHR was unsuitable to fulfill the authors＇ purpose, the free software package ＂Epi Info 7＂ was used to create a template for data entry and analysis. Results： Of the 41 female patients identified with possible osteoporotic fractures, as many as 90% （37 patients） did not have any bone-density measurements recorded despite 39% （16 patients） had been given a diagnosis of osteoporosis. Of the 16 patients with recorded osteoporosis, only two were prescribed antiosteoporotic medication. The EHR was largely inadequate to answer the question. Conclusion： ＂How do I care for mypatients with...？＂ is a difficult question to answer when relying on conventional EHR. The resulting answer is worrying and opens up a lot of room for improvement on behalf of the EHR and the quality of care provided.
