Health Planning

健康规划
  • 文章类型: English Abstract
    我们详细描述了创作的双重建议,负责评估西班牙卫生技术和政策效率及其可能设计的两个机构的组织和顺序发展。这将是重新组织国家卫生系统过程中的一个关键因素。第一,可以立即采用,将被称为药品效率评估办公室,将作为一个功能独立的机构隶属于西班牙药品和医疗器械局,仅限于评估药品的效率。第二个,国家健康评估委员会,以独立的行政机构的形式,将评估卫生技术和可能的公共卫生政策。功能独立,充足的资源和良好治理价值观的锚定是这一双重建议的决定性特征。
    We describe in detail a twofold proposal for the creation, organization and sequential development of two bodies responsible for evaluating the efficiency of health technologies and policies in Spain and its possible design. It would constitute a key element in the process of re-organising the National Health System. The first, which could be adopted immediately, would be called the Office for the Evaluation of the Efficiency of Medicines, would be attached to the Spanish Agency for Medicines and Medical Devices as a functionally independent body and limited to evaluating the efficiency of medicines. The second, the National Health Evaluation Commission, in the form of an independent administrative body, would evaluate health technologies and possibly public health policies. Functional independence, adequate resources and anchoring in the values of good governance are the defining characteristics of this dual proposal.
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  • 文章类型: English Abstract
    Liver diseases are a significant global cause of morbidity and mortality. Liver cirrhosis can result in severe complications such as bleeding, hepatic encephalopathy (HE), and infections. Implementing a clear strategy for intensive care unit (ICU) admission management improves patient outcomes. Hemodynamically significant esophageal/gastric variceal bleeding (E/GVB) and grade 4 HE, when accompanied by the need for renal replacement therapy (RRT), are definitive indications for ICU admission. E/GVB, spontaneous bacterial peritonitis (SBP), and infections with multidrug-resistant organisms (MDRO) require close and stringent critical assessment. Patients with severe hepatorenal syndrome (HRS) or respiratory failure have increased baseline mortality and most likely benefit from early ICU treatment. Rapid identification of sepsis in patients with liver cirrhosis is a crucial criterion for ICU admission. Prioritizing cases based on mortality risk and clinical urgency enables efficient resource utilization and optimizes patient management. In addition, \"Liver Units\" provide an intermediate care (IMC) level for patients with liver diseases who require close monitoring but do not need immediate intensive care.
    UNASSIGNED: Lebererkrankungen sind global eine bedeutende Ursache für Morbidität und Mortalität. Leberzirrhose kann zu schwerwiegenden Komplikationen wie Blutungen, hepatischer Enzephalopathie (HE) und Infektionen führen. Eine klare Strategie zum Aufnahmemanagement auf die Intensivstation (ITS) verbessert die Patientenversorgung. Hämodynamisch relevante Ösophagus‑/Magenvarizenblutungen (ÖVB/MVB) und eine HE Grad 4, begleitet von der Notwendigkeit einer Nierenersatztherapie (NET), sind definitive Indikationen für eine Aufnahme auf die ITS. ÖVB/MVB, spontane bakterielle Peritonitis (SBP) und Infektionen mit multiresistenten Erregern (MRE) erfordern eine hochkritische Bewertung. Patienten mit schwerem hepatorenalen Syndrom (HRS) oder respiratorischem Versagen weisen eine erhöhte Basismortalität auf und profitieren mit hoher Wahrscheinlichkeit von einer frühzeitigen Behandlung auf der ITS. Die rasche Identifizierung von Sepsis bei Patienten mit Leberzirrhose ist ein entscheidendes Kriterium für die Aufnahme auf die ITS. Eine Fallpriorisierung basierend auf dem Mortalitätsrisiko und der klinischen Dringlichkeit ermöglicht eine effiziente Ressourcennutzung und optimiert das Patientenmanagement. Zusätzlich bieten „Liver Units“ eine Versorgungsebene mit Intermediate-Care(IMC)-Standard für Patienten mit Lebererkrankungen, die eine engmaschige Überwachung, aber keine unmittelbare intensivmedizinische Behandlung benötigen.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    全球融资基金(GFF)支持国家生殖,母性,新生,孩子,青少年健康,和营养需求。先前的分析审查了GFF11个伙伴国家的GFF国家规划文件中如何代表青少年性健康和生殖健康。
    本文进一步分析了16个GFF伙伴国家,作为特别系列的一部分。
    对公开的GFF阿富汗规划文件进行了内容分析,布基纳法索,柬埔寨,汽车,科特迪瓦,几内亚,海地,印度尼西亚,马达加斯加,马拉维,马里,卢旺达,塞内加尔,塞拉利昂,塔吉克斯坦,越南。分析考虑了青少年健康内容(心态),与青少年性健康和生殖健康需求相关的指标(衡量标准)和资金(资金),使用示踪剂指示器。
    青少年怀孕率较高的国家,与青少年生殖健康有关的内容较多,在脆弱的环境中例外。投资案例比项目评估文件具有更多的青春期内容。内容从心态到手段再到金钱逐渐弱化。相关条件,比如瘘管,流产,和心理健康,没有得到充分的解决。布基纳法索和马拉维的文件表明,即使在转移或选择性优先事项的背景下,也有可能纳入青少年方案。
    追踪优先次序并将承诺转化为计划为讨论全球青少年资金提供了基础。我们强调方案拟订的积极方面和加强的领域,并建议将青少年健康的视角扩大到生殖健康之外,以涵盖各种问题,比如心理健康。这篇论文是越来越多的问责文献的一部分,支持青少年规划和资助的宣传工作。
    主要发现:全球融资机制国家文件中包含的青少年健康内容不一致,尽管有强有力或积极的例子,投资案例中的内容比项目评估文件强,并在比较内容时减少,指标和融资。补充知识:尽管在18岁之前出生比例最高的国家中,青少年健康内容通常最强,但在脆弱的情况下也有例外,在解决与青少年健康有关的重要问题方面存在差距。全球卫生对政策和行动的影响:全球融资基金支持的青少年卫生规划应以强有力的国家计划为例,在解决青少年健康问题上更加一致,并伴随着公众透明度,以促进诸如此类的问责工作。
    The Global Financing Facility (GFF) supports national reproductive, maternal, newborn, child, adolescent health, and nutrition needs. Previous analysis examined how adolescent sexual and reproductive health was represented in GFF national planning documents for 11 GFF partner countries.
    This paper furthers that analysis for 16 GFF partner countries as part of a Special Series.
    Content analysis was conducted on publicly available GFF planning documents for Afghanistan, Burkina Faso, Cambodia, CAR, Côte d\'Ivoire, Guinea, Haiti, Indonesia, Madagascar, Malawi, Mali, Rwanda, Senegal, Sierra Leone, Tajikistan, Vietnam. Analysis considered adolescent health content (mindset), indicators (measure) and funding (money) relative to adolescent sexual and reproductive health needs, using a tracer indicator.
    Countries with higher rates of adolescent pregnancy had more content relating to adolescent reproductive health, with exceptions in fragile contexts. Investment cases had more adolescent content than project appraisal documents. Content gradually weakened from mindset to measures to money. Related conditions, such as fistula, abortion, and mental health, were insufficiently addressed. Documents from Burkina Faso and Malawi demonstrated it is possible to include adolescent programming even within a context of shifting or selective priorities.
    Tracing prioritisation and translation of commitments into plans provides a foundation for discussing global funding for adolescents. We highlight positive aspects of programming and areas for strengthening and suggest broadening the perspective of adolescent health beyond the reproductive health to encompass issues, such as mental health. This paper forms part of a growing body of accountability literature, supporting advocacy work for adolescent programming and funding.
    Main findings: Adolescent health content is inconsistently included in the Global Financing Facility country documents, and despite strong or positive examples, the content is stronger in investment cases than project appraisal documents, and diminishes when comparing content, indicators and financing.Added knowledge: Although adolescent health content is generally strongest in countries with the highest proportion of births before age 18, there are exceptions in fragile contexts and gaps in addressing important issues related to adolescent health.Global health impact for policy and action: Adolescent health programming supported by the Global Financing Facility should build on examples of strong country plans, be more consistent in addressing adolescent health, and be accompanied by public transparency to facilitate accountability work such as this.
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  • 文章类型: Journal Article
    背景:实现全民健康覆盖需要使用研究证据来指导决策。然而,关于在中低收入国家规划中使用研究证据的信息很少,包括坦桑尼亚。本文提出了一个协议,旨在调查研究证据在健康规划中的使用情况,在坦桑尼亚,规划团队成员使用知识翻译工具的决定因素和准备情况。
    方法:本研究将采用序贯探索性混合方法设计,参与者从国家中挑选出来,区域和理事会级别。定性数据将通过最多52次深入访谈和12次重点小组讨论收集,直至饱和。为了收集定量数据,一份结构化问卷将用于调查422名参与者,并将对卫生设施进行文件审查。定性数据将使用主题分析进行分析,而描述性和推断性分析将用于定量数据。
    背景:研究参与者将提供书面知情同意书,所有记录的数据将存储在一个安全的研究服务器上,只有研究者可以访问。道德批准已从多多马大学研究伦理委员会获得(参考。MA.84/261/02/\'A\'/64/91)。这项研究的结果将告知决策者,研究人员和实施者在决策中使用研究证据。我们将通过出版物传播我们的发现,会议,研讨会和与国家的互动交流,区域,理事会和医疗机构规划小组。
    BACKGROUND: Achieving universal health coverage requires using research evidence to inform decision-making. However, little information is available on the use of research evidence in planning in lower middle-income countries, including Tanzania. This paper presents a protocol that aims to investigate the usage of research evidence in health planning, determinants and readiness of the planning team members to use knowledge translation tools in Tanzania.
    METHODS: This study will employ a sequential exploratory mixed-methods design, with participants selected from national, regional and council levels. Qualitative data will be collected through a maximum of 52 in-depth interviews and 12 focused group discussions until saturation. To collect quantitative data, a structured questionnaire will be used to survey 422 participants, and a document review will be conducted from health facilities. Qualitative data will be analysed using thematic analysis, while descriptive and inferential analyses will be employed for quantitative data.
    BACKGROUND: The study participants will provide written informed consent, and all recorded data will be stored on a secured research server accessible only to the investigators. Ethical approval has been obtained from the University of Dodoma Research Ethics Committee (ref. MA.84/261/02/\'A\'/64/91). The findings of this study will inform policymakers, researchers and implementers in the country on the use of research evidence in decision-making. We will disseminate our findings through publications, conferences, workshops and interactive communication with national, regional, council and health facility planning teams.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    卫生部门的规划和预算与确定指导预算分配以改善卫生结果的优先事项有关。让社区参与这个过程使他们能够管理自己的健康。尽管立法和结构对主流社区参与有好处和可用性,他们的参与很少,而且充满了挑战。这项研究,因此,旨在研究卫生管理人员对社区卫生委员会(CHC)参与卫生部门规划和预算的水平和观点。
    这项研究采用了横断面研究设计,结合定量和定性研究方法。研究参与者参与了计划和预算。定量数据来自100%(n=170)的健康管理者,而定性数据来自100%(n=3)的县卫生部门高管和94%(n=83)的社区卫生委员会成员。描述性统计被用来分析定量数据,而定性数据则进行了主题分析。
    尽管87%的健康管理者同意社区卫生委员会的参与是有益的,只有11%的人对他们的参与感到满意,54%的人认为CHC参与率较低;此外,超过50%的卫生管理人员不同意社区卫生单位(CHU)具有有效参与该过程的必要技能,为CHC的参与分配了足够的预算和时间,并向他们提供有关该过程的反馈。
    县卫生部门应分配更多资金并设计持续的能力建设计划,以加强CHC对卫生部门规划和预算的参与。
    UNASSIGNED: health sector planning and budgeting are concerned with identifying priorities that guide budgetary allocation to improve health outcomes. Engaging the community in this process empowers them to manage their own health. Despite the benefits and the availability of legislation and structures to mainstream community participation, their involvement is minimal and marred with challenges. This study, therefore, aimed to examine the level and perspectives of health managers on community health committees´ (CHC) participation in health sector planning and budgeting.
    UNASSIGNED: the study utilized a cross-sectional research design, incorporating both quantitative and qualitative research methods. Study participants were involved in planning and budgeting. Quantitative data were collected from 100% (n=170) of health managers, while qualitative data were gathered from 100% (n=3) of county department of health executives and 94% (n=83) of community health committee members. Descriptive statistics were utilized to analyze quantitative data, while qualitative data were analyzed thematically.
    UNASSIGNED: although 87% of the health managers agreed that community health committee participation is beneficial, only 11% of them were satisfied with their participation, and 54% rated CHC participation as low; furthermore, over 50% of health managers disagreed that Community Health Unit (CHUs) have the necessary skills to effectively participate in the process, that adequate budget and time are allocated for CHC participation, and that feedback about the process is provided to them.
    UNASSIGNED: the county health department of health should allocate more funds and design sustained capacity-building programs to enhance CHC participation in health sector planning and budgeting.
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  • 文章类型: English Abstract
    目标:加泰罗尼亚卫生服务局开展服务提供和组织的运营规划。目标是描述执行这些功能所遵循的方法和程序。
    方法:医疗保健服务(OPHS)的运营计划过程是连续的,动态,参与性,目标,和适应性。OPHS在实施和评估之前可以分为三个阶段:服务交付计划,医疗保健资源的组织,和采购规划。
    结果:按照POSS框架介绍了三个项目示例。必须使流程适应每个项目的特点。
    结论:所提出的框架有助于实现高质量和公平的服务获取。
    OBJECTIVE: The Catalan Health Service carries out the operational planning of service delivery and organization. The goal is to describe the methodology and procedure followed to perform these functions.
    METHODS: The process of operational planning in healthcare services (OPHS) is continuous, dynamic, participatory, objective, and adaptable. OPHS can be divided into three stages prior to implementation and evaluation: Service delivery planning, Organization of healthcare resources, and Procurement planning.
    RESULTS: Three examples of projects are presented following the POSS framework. It is essential to adapt the process to the characteristics of each project.
    CONCLUSIONS: The proposed framework is useful to achieve high quality and equity in access to services.
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  • 文章类型: Journal Article
    卫生劳动力计划的方法之一是基于供应的。有人强调,各国应根据证据及其背景对卫生人力进行建模。这项研究的目的是“为伊朗的专业和亚专业设计供应卫生劳动力计划模型。\“
    这是一项使用Walker和Avant\的(2018)理论综合框架构建模型的研究。该方法有三个步骤。根据研究团队的观点和国家的需要,焦点概念确定。然后,进行了文献综述以确定相关因素及其关系.第三步,根据审查,研究小组的观点,组件之间连接的基本原理,并给出了图形模型。
    选择“供应”作为焦点概念。在文献综述中,从系统评价中获得了42个组件,从其他文本的研究中获得的43个组件与研究小组关于伊朗领域的意见相结合,并确定了它们之间的联系。第三步,供应模型是使用库存和流量方法设计的。最后,通过应用“功能全时系数”,计算了全职同等医师的人数.
    提出的模型是一个基于证据的模型,遵循库存和流量设计。库存是劳动力市场中存在的专业或亚专业的数量。根据伊朗的教育途径,流动包括流入和流出。
    UNASSIGNED: One of the approaches to health workforce planning is supply-based. It has been emphasized that countries should model health workforce based on evidence and their context. The objective of this study is to \"design a supply health workforce planning model for specialty and subspecialty in Iran.\"
    UNASSIGNED: This is a study using Walker and Avant\'s (2018) theory synthesis framework to construct the model. This method has three steps. According to the viewpoint of the research team and the needs of the country, the focal concept is determined. Then, a literature review was done to determine related factors and their relationships. In the third step, according to the review, the viewpoint of the research team, the rationale of the connection between components, and the graphic model were presented.
    UNASSIGNED: \"Supply\" was selected as the focal concept. In the literature review, 42 components were obtained from the systematic review, 43 components obtained from the study of other texts were combined with the opinion of the research team about the field of Iran, and the connections between them were determined. In the third step, the supply model was designed using the Stock and Flow method. Finally, by applying the \"functional full-time coefficient\", the number of full-time equivalent physicians was calculated.
    UNASSIGNED: The presented model is an evidence-based model that follows stock and flow design. Stock is the number of specialties or subspecialties that exist in the labor market. Flow includes inflow and outflow according to the educational pathway in the context of Iran.
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