universal health coverage

全民健康覆盖
  • 文章类型: Journal Article
    UNASSIGNED: The WHO emphasises that rehabilitation services must be integrated into primary healthcare as an inherent part of universal health coverage. However, there is limited research on the integration of rehabilitation services in primary healthcare in low- and middle-income countries. The purpose of this paper is to identify and describe the literature on service guidelines, models, and protocols that support the integration of rehabilitation services in primary healthcare in the BRICS countries (Brazil, Russia, India, China, and South Africa).
    UNASSIGNED: A scoping review guided by Arksey and O\'Malley\'s framework was conducted. Structured database and website searches identified published and unpublished records from 2010, which were subjected to eligibility criteria. Mendeley, JBI SUMARI, and Microsoft Excel were used to extract and synthesise the data.
    UNASSIGNED: The search strategy identified 542 records. Thirty-two records met the inclusion criteria. Shared care and community-based rehabilitation were the most reported practice models, and the implementation of the models, guidelines, and protocols was mostly described in mental health services.
    UNASSIGNED: This review discusses BRICS countries\' rehabilitation service guidelines, models, and protocols for primary healthcare integration and implementation challenges. Rehabilitation professionals should rethink, realign, and apply existing models because of the lack of primary healthcare integration directives.
    The integration of rehabilitation services in low-resourced and remote settings can be improved by involving community health workers and community rehabilitation workers in transdisciplinary teams.Peer support workers and community health workers can improve rehabilitation outcomes, particularly through shared care models that emphasize peer-to-peer learning, mentoring, and coaching.Self-management interventions can have a positive impact on functional outcomes.Integrated rehabilitation services in primary healthcare can be supported through community-based rehabilitation, which emphasises community involvement and engagement.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    The World Health Organization Model List of Essential Medicines has led to at least 137 national lists. Essential medicines should be grounded in evidence-based guideline recommendations and explicit decision criteria. Essential medicines should be available, accessible, affordable, and the supporting evidence should be accompanied by a rating of the certainty one can place in it. Our objectives were to identify criteria and considerations that should be addressed in moving from a guideline recommendation regarding a medicine to the decision of whether to add, maintain, or remove a medicine from an essential medicines list. We also seek to explore opportunities to improve organizational processes to support evidence-based health decision-making more broadly.
    We conducted a qualitative study with semistructured interviews of key informant stakeholders in the development and use of guidelines and essential medicine lists (EMLs). We used an interpretive descriptive analysis approach and thematic analysis of interview transcripts in NVIVO v12.
    We interviewed 16 key informants working at national and global levels across all WHO regions. We identified five themes: three descriptive/explanatory themes 1) EMLs and guidelines, the same, but different; 2) EMLs can drive price reductions and improve affordability and access; 3) Time lag and disconnect between guidelines and EMLs; and two prescriptive themes 4) An \"evidence pipeline\" could improve coordination between guidelines and EMLs; 5) Facilitating the link between the WHO Model List of Essential Medicines (WHO EML) and national EMLs could increase alignment.
    We found significant overlap and opportunities for alignment between guideline and essential medicine decision processes. This finding presents opportunities for guideline and EML developers to enhance strategies for collaboration. Future research should assess and evaluate these strategies in practice to support the shared goal of guidelines and EMLs: improvements in health.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    UASSIGNED:标准治疗指南(STGs)是经过时间考验的工具,可提高医疗质量和患者安全。这项研究是为了审查可用的指南,并使用2016年AGREE报告清单评估其基本属性。
    UNASSIGNED:PubMed的出版物,世界卫生组织,全球卫生区域图书馆,IndexMedicus,Google,谷歌学者,和保险公司,搜索了州/中央政府门户网站。
    未经批准:总共,241名STGs符合纳入标准。一系列具有不同重点和优先事项的开发人员制定了这些指南(政府主要根据国家计划134(56%);专业协会67(28%),学术/研究机构36(15%);国际机构4[2%])。政府主导的指导方针侧重于项目运营(主要是感染,母性,和儿童保育),而保险公司专注于外科手术,以防止欺诈索赔意图。可用的STGs在开发过程的严谨性方面差异很大,最终用户的参与,更新,适用性,等。;12%的指南制定了记录的证据等级标准。大多数指南都集中在初级保健上,只有27%和7%包括三级和二级治疗,分别,专注于全科医生。
    UNASSIGNED:需要协调,以及协作努力制定循证指南,促进定期修订,标准化的开发过程,以及指南中嵌入的监测标准。制定标准治疗指南的单一指定机构和基于网络的中央存储库,临床医生/用户可以免费访问,这将确保广泛访问质量指南,从而提高接受度和管理水平。
    UNASSIGNED: Standard Treatment Guidelines (STGs) are time-tested tool to improve healthcare quality and patient safety. This study was done to review the available guidelines and assess their essential attributes using AGREE reporting checklist 2016.
    UNASSIGNED: Publications from PubMed, World Health Organization, Global Health Regional Libraries, Index Medicus, Google, Google Scholar, and insurers, state/central government portals were searched.
    UNASSIGNED: In total, 241 STGs met the inclusion criteria. A range of developers with a varying focus and priorities developed these guidelines (government mostly under national programs 134 (56%); professional associations 67 (28%), academic/research institutions 36 (15%); international agencies 4 [2%]). The government-led guidelines focused on program operations (mainly infections, maternal, and childcare), whereas insurers focused on surgical procedures for protection against fraudulent intentions for claims. The available STGs varied largely in terms of development process rigor, end-user involvement, updation, applicability, etc.; 12% guidelines developed documented GRADE criteria for evidence. Most guidelines focused on the primary care, and only 27 and 7% included treatment at tertiary and secondary levels, respectively, focused on general practitioners.
    UNASSIGNED: There is a need for coordinated, and collaborative efforts to generate evidence-based guidelines, facilitate periodic revisions, standardized development process, and the standards for monitoring embedded in the guidelines. A single designated authority for the standard treatment guidelines development and a central web-based repository with free access for clinicians/users will ensure wide access to quality guidelines enhancing acceptance and stewardship.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    目标:作为世卫组织2030年康复行动呼吁的一部分,世卫组织康复计划正在制定其康复干预措施一揽子计划(PIR),以支持全球卫生部将康复服务纳入卫生系统。作为PIR开发的重要一步,我们对痴呆症临床实践指南(CPGs)进行了系统评价,以确定康复干预措施和相关证据.
    方法:遵循WHO康复计划和Cochrane康复方法,2010年1月至2020年3月以英文发布的质量CPG是使用PubMed,Embase,CINAHL,PEDro,谷歌学者,指南数据库,和专业社会网站。使用《研究与评价指南评价》(II)对指南质量进行了评估。
    结果:在符合选择标准的22个CPG中,六项满足质量评价。三百三十条有关康复的建议,被确认,主要集中在认知领域,情感和照顾者的支持。有许多强有力的干预措施,具有中等到高质量的证据,可以很容易地在常规实践中引入。然而,在证据的质量和范围上都发现了主要的局限性,特别是在教育和职业等领域,社区和社会生活,和生活方式的改变。
    结论:需要进一步严格的研究来建立一般痴呆康复的质量证据,尤其是在被忽视的康复领域。未来的工作还应侧重于开发用于痴呆症康复的CPG。需要多管齐下的方法来实现痴呆症康复的全民健康覆盖。
    As part of the WHO Rehabilitation 2030 call for action, the WHO Rehabilitation Programme is developing its Package of Interventions for Rehabilitation (PIR) to support ministries of health around the globe in integrating rehabilitation services into health systems. As a vital step for this PIR development, we conducted a systematic review of clinical practice guidelines (CPGs) for dementia to identify interventions for rehabilitation and related evidence.
    Following WHO Rehabilitation Programme and Cochrane Rehabilitation\'s methodology, quality CPGs published in English between January 2010 and March 2020 were identified using PubMed, Embase, CINAHL, PEDro, Google Scholar, guideline databases, and professional society websites. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (II).
    Of the 22 CPGs that met the selection criteria, 6 satisfied the quality evaluation. Three hundred and thirty rehabilitation-related recommendations were identified, mostly concentrated in the areas of cognition, emotion, and carer support. There were many strong interventions, with moderate- to high-quality evidence that could be easily introduced in routine practice. However, major limitations were found both in the quality of evidence and scope, especially in areas such as education and vocation, community and social life, and lifestyle modifications.
    Further rigorous research is needed to build quality evidence in dementia rehabilitation in general, and especially in neglected areas for rehabilitation. Future work should also focus on the development of CPGs for dementia rehabilitation. A multipronged approach is needed to achieve Universal Health Coverage for dementia rehabilitation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    这份共识文件的目的是召集来自美国护理学会八个专家小组的领导人和学者,并提供建议,以提高护理的作用和责任,以确保普遍获得姑息治疗。本共识文件的第一部分提供了支持该政策的理由和背景,教育,研究,和第二部分提出的临床实践建议。我代表学院,基于证据的建议将指导护士,政策制定者,政府代表,专业协会,以及跨学科和社区合作伙伴,将姑息护理服务整合到整个健康和社会护理环境中。该共识论文的43位作者代表八个国家(澳大利亚,加拿大,英格兰,肯尼亚,黎巴嫩,利比里亚,南非,美利坚合众国)和丰富的国际卫生经验,从而为主题提供了全球背景。作者建议加大对姑息护理教育和护士主导研究的投资,护士参与政策制定,加强与护理的部门间伙伴关系,以及全球姑息护士的知名度和知名度的提高。通过制定这些建议,在所有环境中工作的护士都可以在全球提供高质量的姑息治疗方面发挥主导作用,特别是对于小人化,边缘化,和其他高危人群。
    The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing\'s roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper\'s 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Practice Guideline
    The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing\'s roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper\'s 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    The WHO Consultative Group on Equity and Universal Health Coverage published a comprehensive report titled \"Making Fair Choices on the Path to Universal Health Coverage\" detailing strategies that countries should adopt when moving towards providing healthcare coverage to the entire population. The report provides detailed guidelines on how to expand coverage to more people, what services should be covered, and how to prioritize these healthcare resources in achieving universal healthcare coverage (UHC). The main goal of this WHO report is to ensure fair and equitable access for all population groups within a country during the implementation of UHC. In principle, the group\'s approach is sound and fair, but we argue that each country must take into account its own unique situations in designing a pathway towards UHC. China has achieved near UHC but did so by an approach that would have been deemed completely unacceptable based on this group\'s recommendations. In this article, we provide a brief review of the Chinese healthcare system and argue that the implementation of the recommendations in the report is not always feasible. We argue that there are alternate pathways towards achieving UHC and there are good reasons for China\'s departure from the approach outlined by the WHO report. Nevertheless, we acknowledge substantial inequities still exist for various segments of the population and among the diverse areas of China in accessing healthcare services and make suggestions on how to reduce such inequities within the system.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:据报道,政府对COVID-19的反应各不相同。这项研究的目的是对墨西哥医疗机构在COVID-19期间发布的医疗政策进行探索性审查。在墨西哥,由于医疗保健系统的长期分散和健康不平等,必须分析不同卫生子系统内的政策。
    方法:分析中故意包含的政策由四家公共卫生机构发布(IMSS,ISSSTE,SSA和PEMEX)在墨西哥COVID-19流行期间(2月29日至6月15日,2020)在官方机构网站上。研究人员审查了每份文件,并将其分为由快速研究评估和评估实验室(RREAL)设定的七个政策类别:公共卫生响应,卫生保健服务,人力资源,卫生系统基础设施和用品,临床反应,卫生保健管理,和流行病学监测。
    结果:政策类型因医疗机构而异。最多的政策是针对公共卫生对策,其次是提供保健和人力资源。政策主要在社区传播阶段发布。
    结论:大流行暴露了潜在的医疗保健系统不平等以及对疫情的反应性而非准备性反应。此外,这项研究概述了未来可以避免的潜在政策差距和反应延迟.
    BACKGROUND: Heterogeneous government responses have been reported in reaction to COVID-19. The aim of this study is to generate an exploratory review of healthcare policies published during COVID-19 by health-care institutions in Mexico. Analyzing policies within different health sub-systems becomes imperative in the Mexican case due to the longstanding fragmentation of the health-care system and health inequalities.
    METHODS: Policies purposely included in the analysis were published by four public health institutions (IMSS, ISSSTE, SSA and PEMEX) during the COVID-19 epidemic in Mexico (from February 29th to June 15th, 2020) on official institutional websites. Researchers reviewed each document and classified them into seven policy categories set by the Rapid Research Evaluation and Appraisal Lab (RREAL): public health response, health-care delivery, human resources, health-system infrastructure and supplies, clinical response, health-care management, and epidemiological surveillance.
    RESULTS: Policy types varied by health institution. The largest number of policies were aimed at public health responses followed by health-care delivery and human resources. Policies were mainly published during the community transmission phase.
    CONCLUSIONS: The pandemic exposed underlying health-care system inequalities and a reactive rather than prepared response to the outbreak. Additionally, this study outlines potential policy gaps and delays in the response that could be avoided in the future.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:由于2009年开始的医疗改革,中国已经为其95%的人口(>13亿人的生命)实现了近乎全民健康覆盖(UHC)。然而,中国医疗体系中许多遗留问题之一是需要更好地优化医疗资源的分配和使用,以满足日益增长的医疗需求。
    目的:目的是重点介绍2020年版《中国药物经济学评价指南》(CGPE)的组成部分,并讨论其在中国UHC的未来发展。
    方法:我们回顾了CGPE2020版的开发过程,讨论中国UHCCGPE的当代实践,描述CGPE的新机遇和挑战,并根据中国医疗系统的现状,对CGPE的未来发展提出建议。
    结果:药物经济学提供了以科学的方式评估药品的健康回报和经济成本的工具,以实现医疗保健资源的最佳分配。考虑到药物经济学在中国的巨大潜力,在过去十年中,它作为一个研究领域的快速发展和认可证明了这一点,药物经济学评价的规范化对于提高用于药物选择的评价结果的准确性尤为重要,价格谈判和调整。
    结论:建议将CGPE整合到中国当前的UHC框架中,包括规范药物经济学评估过程和更新CGPE主题,如伦理和现实世界的研究。CGPE2020版提供了提高药物经济学评价研究质量、提升我国UHC价值和效率的标准。
    BACKGROUND: China has achieved near-universal health coverage (UHC) for 95 percent of its population (>1.3 billion lives) as a result of healthcare reforms that began in 2009. However, one of many remaining issues in the Chinese healthcare system is the need to better optimize the allocation and use of healthcare resources in order to meet growing healthcare demands.
    OBJECTIVE: The goals are to highlight the components of the China Guidelines for Pharmacoeconomic Evaluations (CGPE) 2020 Edition and discuss its future development for UHC in China.
    METHODS: We review the development process of the CGPE 2020 edition, discuss the contemporary practice of the CGPE for UHC in China, describe new opportunities and challenges to the CGPE, and provide suggestions on the future development of the CGPE based on the current state of the healthcare system in China.
    RESULTS: Pharmacoeconomics provides tools to evaluate the health returns and economic costs of pharmaceutical products in a scientific way for the optimal allocation of healthcare resources. Considering the great potential of pharmacoeconomics in China, demonstrated by its rapid development and recognition as a research field in the past decade, the standardization of pharmacoeconomic evaluations has become particularly important to improve the accuracy of evaluation results used for drug selection, price negotiations and adjustments.
    CONCLUSIONS: Suggestions are made for the integration of CGPE into current framework of UHC in China, including standardizing the pharmacoeconomic evaluation process and updating CGPE on topics such as ethics and real-world research. The CGPE 2020 edition offers a standard to improve the quality of pharmacoeconomic evaluation research and enhance the value and efficiency of UHC in China.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    Definitions of health systems strengthening (HSS) have been limited in their inclusion of communities, despite evidence that community involvement improves program effectiveness for many health interventions. We review 15 frameworks for HSS, highlighting how communities are represented and find few delineated roles for community members or organizations. This review raises the need for a cohesive definition of community involvement in HSS and well-described activities that communities can play in the process. We discuss how communities can engage with HSS in four different areas-planning and priority-setting; program implementation; monitoring, evaluation, and quality improvement; and advocacy-and how these activities could be better incorporated into key HSS frameworks. We argue for more carefully designed interactions between health systems policies and structures, planned health systems improvements, and local communities. These interactions should consider local community inputs, strengths, cultural and social assets, as well as limitations in and opportunities for increasing capacity for better health outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号