bsstar服务管理体系的文件要求(12).ppt

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1、Community Health 1.1,1,Public Health Practice and Improvement Framework Practices and Essential Services 公共卫生实践,改善框架-实践和关键服务-,Community Health 1.1,2,Public Health Infrastructure Goal公共卫生基础设施目标,Every health department better prepared 每一个卫生部门都应该准备好 Every community better protected 每一个社区都受很好的保护,What do

2、es it take to be fully prepared? 如何才能做好充分的准备?,销售管理软件 ,Community Health 1.1,3,Step One第一步,Develop a Community Health Assessment Plan制定社区卫生评估计划 Gather Most Important Data收集重要数据 Interpret the Data对数据进行分析 Report 撰写报告 brief,简洁 to the point, 重点突出 clear data 数据明晰 specific recommendations明确的建议,Community Hea

3、lth 1.1,4,AssessmentEssential Services评价关键服务,Community Health 1.1,5,Causes of Premature Death in the U.S. 19901990年美国过早死亡的原因,Cause原因 % of Total Deaths总死亡 Tobacco烟草38% Diet/activity patterns饮食/运动模式28% Alcohol酒精10% Microbial agents微生物8% Toxic agents毒物 6% Firearms 枪支 4% Sexual behavior 性行为 2% Motor veh

4、icles 交通事故 2% Illicit drugs 非法毒品 1%,Source: McGinnis & Foege, JAMA 1993,What would be the leading causes in China? 在中国首要原因是什么?,Community Health 1.1,6,What is Most Important to Monitor?Some possible criteria监测的重点是什么?一些可能的标准,Contribute most to years of productive life lost?是否导致生产年的丧失? Affects other re

5、gions and countries?是否影响其他的区域和国家? Could be improved greatly with good data是否可以通过好的数据显著改善健康状况?,0,Community Health 1.1,7,Top Three Health Problems?,_ Aging problems 老龄化 _ Cancers 癌症 _ Child abuse /neglect, orphans 虐待儿童 _ Diabetes 糖尿病 _ Domestic Violence家庭暴力 _ Heart disease/stroke心脏病/中风 _ blood pressur

6、e高血压 _ HIV / AIDS艾滋病 _ Homicide他杀,_ Infant Death 婴儿死亡 _ Infectious Diseases 传染病 _ Mental health problems精神病 _ Car /Bike injuries 车祸 _ Rape性暴力 _ Lung disease 肺病 _ Sexual Diseases性病 _ Suicide 自杀 _ Other:_其他_,Community Health 1.1,8,What Would You Like to Achieve By 2010? 到2010年想要达到什么目标不?,objectives for

7、 change目标 Develop An Objective (By when, what will be changed, by how much change, for what group?)_ 制定目标(何时、取得何种变化、变化多少、目标人群是哪个?),Community Health 1.1,9,Leading Health Indicators主要的健康指标,Biological causes of death, illness, injury导致死亡、疾病、伤害的生物学因素 Behavior and Lifestyle行为与生活方式 Environment: quality of

8、 air, water, food, land环境因素:空气、水、食物、土地的质量 Immunizations免疫接种 Access to health care 卫生保健的获得,Community Health 1.1,10,Services Need to Address All Determinants of Public Health解决公共健康所有决定因素所需要的服务,Community Health 1.1,11,Slide Details: Multiple Determinants of Health 健康的影响因素,Biology 生物学 Behavior 行为 Social

9、, Family & Community Networks 社会,家庭和社区网络 Living & Working Conditions 工作生活环境 Employment & occupation, Education, Socioeconomic status, Psychosocial factors雇佣和职业,教育,社会经济状况,社会心理因素 Natural and built environment 自然和人为环境 Public & health care services 卫生服务 Social, economic, cultural & environmental policie

10、s社会,经济,文化和环境政策,Community Health 1.1,12,Key Components to Monitor Health Status监测卫生现状的关键指标,death certificates if detailed & accurate 死亡登记(详细,准确) immunization registries 免疫接种登记 large population surveys 大人群调查 health interview & exam studies 健康访谈和体检研究 required reporting of key infectious diseases 主要传染性疾

11、病法定报告制度 proxy measures: infant mortality, average lifespan 替代指标:婴儿死亡率,平均寿命 integration across districts, providers, diseases 地区,来源,疾病数据的整合 electronic records: secure, simple, standard variables, updated regularly, well staffed 电子记录:安全,简单,标准变量,经常更新,装备先进,Community Health 1.1,13,Assessment Recommendati

12、ons 评价建议,Develop National Health Information Infrastructure 建立国家卫生信息基础设施 Regularly assess the state of the nations public health system and its capacity to provide the essential public health services to every community 常规评价全国公共卫生系统的现状和为社区提供基本公共卫生服务的能力 Evaluate the status of the nations public healt

13、h laboratory system performance 评价全国公共卫生实验室系统的运行状况,Community Health 1.1,14,Step Two第二步,Develop a Community Health Improvement Plan制定社区健康改善计划 National,国家级 Provincial省级 Local地方 Develop Communication Links Between All Partners在各合作方间建立交流机制,0,Community Health 1.1,15,Policy Development 政策发展,For problems t

14、hat affect large population segments 针对影响最大人群的问题 For problems with roots in environment or institutions or businesses 针对环境,体制或商业的根本 Focus more on improving community wide conditions, services and practices. 重点在提高广泛社区的状况,服务和实践 Can be used to create a more comprehensive and linked public health care s

15、ystem. 可以用于创造一个更综合,紧密连接的公共卫生系统,Community Health 1.1,16,Essential Policy Components That Must Be Put in Place for Success成功的基本要素,Enactment 颁布,Enforcement 实施,Plan for communication between decision makers, and mobilizing support 决策者和支持者之间的交流计划,Plan for communication between authorities, and enough res

16、ources 当局者和足够资源之间的交流计划,Plan for education to increase awareness, and motivation 提高意识和动员水平的教育计划,Compliance 执行,Community Health 1.1,17,Important Policy Components重要的政策要素,Is there a system for identifying and tracking all policies in place? 是否有确认和跟踪政策实施的系统? Is policy compliance monitored and enforced?

17、If not, then there may be no motivation to comply 是否有政策监测系统? Is it clear who has responsibility for each law and how to get them to take action? 每项法律的负责人是否清楚,如何使他们行动起来? Is public informed? 公众是否知情? Does public believe it will be enforced? 公众是否相信政策可行?,Community Health 1.1,18,Policy Recommendations 政策建

18、议,Appoint a national commission to develop a framework for state public health law reform. 任命一个全国委员会建立国家公共卫生法律改革的框架 Support bold, large-scale demonstrations to test new approaches to increase the efficiency and effectiveness of health care delivery systems 支持大规模演示,以检验新方法提高卫生服务系统的有效性,Community Health

19、 1.1,19,Assurance Essential Services 基本服务保证,Enforce public health laws and policies 加强公共卫生法律和政策 Assure a competent public health and personal health care workforce 保证一支有力的公共卫生和个人医疗服务的队伍 Link people to needed personal health services and assure the provision of health care when otherwise unavailable

20、将个人和个人所需的健康服务连接起来 Evaluate compliance, service delivery, health outcomes and need for change 评价依从性,服务,健康产出和改善要求,Community Health 1.1,20,Overview of Health Promotion Strategies健康促进策略回顾,Education: change knowledge, attitudes, beliefs, readiness, intentions and behaviors 教育:改变知识、态度、信仰、愿望、目的和行为 Policy:

21、discourage unhealthy practices, improve infrastructure and environment 政策:不鼓励那些不健康的作法,促进基层单位和环境的改善 Environment: make the environment safer to provide healthy conditions 环境:使之更加安全,以提供健康的环境条件,Community Health 1.1,21,Self-Assessment for Selected Health Issue 卫生问题的自我评价,A strong governmental public healt

22、h infrastructure for leadership and services? 强大的政府公共卫生基础设施 Up-to-date and linked systems for understanding health status and trends? 理解健康状况和趋势的实时监测系统 Clear system of health policies that assure adequate and sustained community health? 确保适当和持续的社区健康的卫生政策系统 Systems in place to protect and enhance the

23、publics health? 保护和加强公众健康的合适系统,Community Health 1.1,22,Mobilize community partnerships to identify and solve health problems 动员社区,确认和解决卫生问题,Governments cannot work alone to tackle big and complex problems 政府不能在解决大的复杂问题上单枪匹马 Poverty, poor food, inadequate wages and lack of physical exercise require c

24、ommunity partnerships 贫穷,差的食物,不适当的工资以及缺少体育锻炼方面需要社区配合 Example: sex trade 例如: 性交易,Community Health 1.1,23,The Public Health Workforce: Is it Ready to Provide the Core Functions and Essential Services at ALL Levels?公共卫生队伍:能否在各个层次上提供核心功能和关键服务,Is there a well developed plan to provide each service? 是否有提供

25、各种服务的成熟计划? Are there enough people and resources? 是否有足够的人员和资源? Are people sufficiently trained? 人员是否经过充分培训? Is it integrated with other essential services? 是否与其它基本服务相整合? Is there good working relationship between the local, regional and national public health systems? 在地方,地区和全国的公共卫生系统之间是否存在良好的工作关系? Is there good communication with other sectors that affect health such as stores and schools? 与影响健康的其它部门,例如商店和学校,之间是否存在良好的沟通与交流?,

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