国外基本卫生服务实施背景、策略及其影响研究  

Strategies to Develop an Essential Healthcare Package: Background, Measures and Impacts Abroad

作　　者：杨莉[1] 王静[1] 曹志辉[1] 孙佳[1] 高军[2] 许文英[1] 吴明[1] 

机构地区：[1]北京大学公共卫生学院卫生政策与管理系,北京100191 [2]卫生部统计信息中心,北京100044

出　　处：《中国循证医学杂志》2010年第3期284-297,共14页Chinese Journal of Evidence-based Medicine

基　　金：中国卫生政策支持项目(HPSP)知识管理领域资助

摘　　要：目的了解国外基本卫生服务实施的背景、策略及效果。方法由主题专家和检索人员讨论并试验后确定检索词,共检索22个电子数据库,50个非政府组织及政府机构网站和搜索引擎Google。纳入所有描述及评价已经实施的基本卫生服务内涵、服务包和遴选原则、实施背景、策略及效果的文献。用自行设计的数据提取表收集文献内容和有关研究质量的信息,对提取信息进行分析和描述。结果共纳入166篇文献,大多数研究来自中低收入国家,主要是关于各国基本卫生服务包内容、遴选原则、实施背景与策略的描述(160篇),涉及效果评价方面的文献极少(6篇)。评价策略的研究大部分为横断面研究,只有1篇是有干预的时间序列研究。结论由于各国政治、历史文化、经济背景以及政策目标的差异,其基本卫生服务政策的实施策略也各不相同,但采取全民覆盖的医疗保险制度和政府提供的基本卫生服务,基本实现卫生服务的全民覆盖,现已成为全世界大多数国家的共识,其中转型国家的经验尤其值得借鉴。Objectives To describe background, measures and impacts of building essential healthcare system in the developed and developing countries aboard. Methods Search words were chosen by both health policy experts and search coordinators after discussion and pilot. The resources we searched included electronic databases, websites of health institutions and governments and search engine Google. Any reports of implemented strategy to develop an essential healthcare package were included. Pre-designed data extraction form was used for collecting strategies and study method of included studies. Then the extracted information was analyzed and described. Result 166 studies covering 72 countries were included, most of which were studies in the middle and low Countries. In terms of study objectives, many studies （160 articles） aimed to describe strategies, while few studies（6 articles） were to evaluate effectiveness of strategies. Most of studies evaluating effectiveness were cross-sectionnary data, Except one time cohort study with intervention. Conclusions Strategies to implement essential healthcare system varies in the different country because of diversity of political, culture and economic background and different goals. The experience in transition countries gives us more high lights.

关 键 词：基本卫生服务 背景 策略 效果 

分 类 号：R197.1[医药卫生—卫生事业管理]