2009年 · 第03卷第03期

Jointly organized by the Health Management Branch of Chinese Medical Association and the Chinese Journal of Health Management, the "Preliminary Consensus of Chinese Experts on Health Management Concept and Discipline System (hereinafter referred to as the 'Preliminary Consensus')" was finally published today. This is worth celebrating and paying attention to the academic theoretical research and practice workers of health management in China. Here, we would like to express our sincere respect to the experts and editors who have worked hard and sweated for the formation of the "Preliminary Consensus", and express our heartfelt thanks to the health management workers, related enterprises and organizations who have always cared, supported and actively participated in the discussion of the "Preliminary Consensus". "Preliminary Consensus" is a general summary of the academic theoretical research and practical exploration of health management in China in the past 10 years. It is an academic masterpiece that adapts to the standardized development of new disciplines and new industries and fully embodies the scientific spirit of "academic contention, seeking common ground while reserving differences" and "advancing with the times and developing innovatively" and the charm of the times. "Seeking common ground and sharing common ground, innovating and developing" is not only the basic principle that the "preliminary consensus" has always been followed, but also the "soul" of in-depth research and practice service of health management in the future. We have reason to believe that the publication of this first "preliminary consensus", which embodies the hard work and efforts of the majority of academic theoretical researchers and practical explorers of health management, will have milestone significance for the construction of China's modern medical science and technology innovation system, the development of new medical disciplines and medical service practices of health management and related industries.

In recent years, with the development of economy, the change of people's health consciousness and the change of medical mode, the term "health management" has become a high-frequency word in both medical institutions and related industries. Although the concept and connotation of health management have not reached consensus at home and abroad, this situation has not affected people's pursuit and exploration of health management practice. In this paper, how to construct the health management model starting from the health examination is discussed.

The increase in the proportion of the elderly population in society is usually referred to as population aging. The most commonly used indicator to reflect aging is the elderly population coefficient, that is, the percentage of people aged ≥60 years or ≥65 years in a society as a percentage of the total population. Aging is considered if 10% of the population aged ≥60 years or 7% of the population aged ≥65 years. The aging index is ≥65 years old population and<Percentage of 15-year-old population, ≥30% is aging. In addition, there are other indicators such as the median age of the population (the median age is younger under 20 years old, adult between 20 and 30 years old, and elderly over 30 years old) and the aging rate, an indicator reflecting the growth rate of the elderly population. It can be seen that if the population in a society reaches the standard of aging, then this society can be called an aging society.

Screening early cancer cases in healthy people to improve therapeutic effect has always been an important part of health management and cancer prevention and treatment^[1,2]However, the health management of cancer survivors and people affected by it is so far scarce in China. This paper reviews its definition, history and present situation, research content and its development trend.

In order to further actively lead and vigorously promote the comprehensive, in-depth research and standardized and orderly development of China's health management from the aspects of academic theoretical research and discipline construction, practical exploration and industry and industry progress, at the beginning of 2009, the Health Management Branch of Chinese Medical Association and Chinese Journal of Health Management held the "2009 China Health Management Discipline System and Scope High-level Forum" (referred to as Tianjin Conference) and the "2009 China Health Management (Physical Examination) Institutional Standardization and Development Summit" (referred to as Suzhou Conference) in Tianjin and Suzhou, Jiangsu on February 28th and March 28th, 2009. Both meetings closely focused on the central topic of "health management concept, discipline system and scope, development goals and principles", and conducted in-depth discussions and full consultations. A "preliminary consensus on the concept and discipline system of health management" (discussion draft) was formed, and then the editorial department of Chinese Journal of Health Management was entrusted to submit the "discussion draft" by email to the standing members of health management branches of Chinese Medical Associations, the chairmen of health management branches of some provincial and municipal medical associations, the editor-in-chief and deputy editor-in-chief of Chinese Journal of Health Management, some editorial members and experts (nearly 40 people in total) for further discussion and revision opinions. In May 2009, the editorial department of Chinese Journal of Health Management carefully sorted out and summarized the consultation opinions and suggestions. According to the combing and summarizing opinions, we revised the "Discussion Draft" again, and finally formed the "Preliminary Consensus of Chinese Experts on Health Management Concept and Discipline System" (referred to as the "Preliminary Consensus"). Although this "preliminary consensus" still has some objections, shortcomings and needs to be continuously improved and improved in the formulation or expression of some terms involved in health management, we believe that the formation and publication of this "preliminary consensus" has milestone significance for the deepening of academic theoretical research on health management in China, the progress of discipline construction and the standardized development of related industries and industries.

China carried out five national censuses in 1953, 1964, 1982, 1990 and 2000 respectively, and carried out sample surveys on population changes in 2001, 2002, 2003, 2004 and 2006, and a sample survey of 1% of the population in 2005. According to the results of the fifth national census in 2000, China has a total population of 1,242,612,226 (excluding the missed registration rate of 1.81%). The total population of middle-aged and elderly persons over the age of 50 is 256,988,000, accounting for 21% of the total population of the country, of which 127,701,000 are males and 129,287,000 are females. The total population of elderly persons over the age of 80 is 11,991,083, of which 7,444,508 are females and 4,546,575 are males. The number of female elderly persons is 1.64 times that of males^[1]。 According to the sample survey of population changes conducted throughout the country in 2006, the total population of the country was estimated to be 1,314,957,001, and the total population of middle-aged and elderly people over 50 years old was 350 016,538, accounting for 26.62% of the total population; The male and female populations were 174,363,298 and 175,653,240, respectively, representing 13.26% and 13.36% of the total population (Table 1，Table 2)。 During the six years between 2000 and 2006, the average annual growth rate of the national population was 0.95%, while the average annual growth rate of the 50-year-old population was as high as 5.2%^[2]。

With the improvement of people's living standard in China in recent 20 years, the morbidity and mortality of cardiovascular diseases are increasing year by year due to the unreasonable diet structure, the acceleration of life rhythm and the aggravation of social psychological pressure. According to the vital statistics released by the Ministry of Health, the death toll of cardiovascular and cerebrovascular diseases in China has accounted for 1/3 of the total death toll. In recent years, it is believed that the change of arterial wall elasticity is the basis for the occurrence and development of various cardiovascular and cerebrovascular diseases, and this change predates the change of structure. Arteriosclerosis is an independent risk factor for cardiovascular events. This study is to use arteriosclerosis detector to detect brachial-ankle Pulse Wave Velocity (baPWV) and brachial-ankle index (ABI) in adult population, to understand the vascular elasticity of adult population, aiming to provide scientific basis for early diagnosis and intervention of vascular lesions, so as to detect arterial dysfunction and intervene early, and reduce the mortality and disability rate of cardiovascular and cerebrovascular diseases.

Malignant tumor is a kind of common and frequently occurring disease, which seriously endangers human health. The purpose of this article is to retrospectively analyze the relevant data of 173 malignant tumors screened during health examinations in our center from 2006 to 2008, and to explore how to choose a more scientific, reliable, low-cost and easy-to-popularize malignant tumor screening method (project) from the perspective of health economics.

health risk appraisal (HRA) is a quantitative assessment technique for individuals and/or groups' health status and risk of morbidity and/or mortality. The progress of epidemiological research results and statistical methods provides theoretical basis for disease risk assessment and makes it possible. This paper mainly introduces the comprehensive analysis methods based on the results of epidemiological studies of a large number of scattered risk factors of chronic diseases in the past. The statistical methods involved mainly include meta-analysis and synthetic analysis.

The theory and practice of health education and health promotion are closely related to health management. Both of them are basically the same in analyzing and solving problems, and both take data collection, needs assessment, intervention implementation and effect evaluation as the main line. However, in terms of methods, health management introduces the concepts of health risk assessment and management, and the other two focus on different emphases. At the same time, health education itself is one of the main means in the implementation of health management intervention. Therefore, learning the theories and methods of health education will greatly help to understand and enrich the theory and practice of health management. This paper will introduce the important theories and methods of health education that are often used in health management practice.

Community health service plays an important role in the construction of medical and health system in China. It is an important way to alleviate the difficulty and expensive medical treatment, and it is the bottom of the basic medical treatment and basic public health. Relevant government departments attach great importance to the development of community health services, and have carried out a series of reforms from the system, aiming at reasonably diverting medical needs, guiding the masses to seek medical treatment in the community, and truly achieving "serious illnesses go to hospitals and minor illnesses in the community", so as to rationally allocate and utilize limited medical and health resources to make them play their role to the maximum extent. Whether it is from the function orientation of "six-in-one" of community health service centers and the work focus of "vulnerable groups", or from the work direction guidance of "moving the gateway forward and moving the center of gravity down", it is not difficult to find that health management is the breakthrough of community health service development and represents the development direction of community health service^[1]。 The author believes that according to the actual situation of manpower, financial resources and technology in community health service centers, the current community health management is mainly aimed at the management of chronic diseases with high incidence.

In the final analysis, health management is the management of human assets, and human assets is an important strategic component of national economic resources^[1]。 In the past 30 years, the United States has experienced a transformation and development of health management practice and research from simple fitness exercise to health promotion, from narrow fitness and health care to comprehensive health promotion and disease management and health management of patients with chronic diseases, common diseases and frequently-occurring diseases. In this process, the Center for Health Management Research of the University of Michigan is committed to the research of economic benefits of corporate health in the United States, and has achieved the world leading position in this research field, and has become one of the recognized authoritative institutions in the research of corporate health management in the United States.Table 1List the major contributions of the University of Michigan Health Management Research Center to corporate health research in the United States over the past three decades^[1]。

Hepatitis B virus (HBsAg) is a global infectious disease. There are about 300 million hepatitis B virus surface antigen (HBsAg) carriers, accounting for 5% of the world's population^[1]。 After human infection with hepatitis B virus, the course of the disease often prolongs and turns into chronic hepatitis, liver cirrhosis and even liver cancer, which has become a serious infectious disease that threatens human health. In 1992, the national seroepidemiological survey showed that the positive rate of HBsAg in the whole population was 9.75% and the total infection rate of hepatitis B virus (HBV) was 57.63%^[2]。 Vaccination with hepatitis B vaccine is an effective way to prevent hepatitis B. In recent years, with the increase of health publicity, more and more people realize the harm of hepatitis B to human body and the important role of hepatitis B vaccine in preventing hepatitis B disease. Therefore, vaccination with hepatitis B vaccine among healthy people is also gradually promoted. Since 2006, our hospital has collected two-and-a-half hepatitis B results of 2,678 healthy examiners who have not been vaccinated with hepatitis B vaccine for the health examination population of employees in fixed units, and vaccinated some of them with hepatitis B vaccine. The follow-up analysis results are reported as follows.

At present, health has become the hotspot, difficulty and focus of common concern of the general public. What is health? Health is economy, health is harmony, health is responsibility, health is gold. In short, health is productivity, and gross domestic product (GDP) is the combined strength of a country. Medicine is divided into four stages: health promotion, disease prevention, and emphasis on cultural and social sciences; The latter two stages originate from the category of medical care and are downstream, focusing on science and technology and natural sciences.

With the rapid development of China's economy, the level of social civilization has also been improved. People have a strong demand for health care behind the prosperous economy, and health-related industries have also continuously developed and expanded. As early as the 2004 Health Industry Forum, Professor Han Qide, vice chairman of the National People's Congress, pointed out^[1]: The establishment of health management services, including health examination, health education and health promotion, can not only effectively prevent or delay the occurrence of diseases, improve health conditions and reduce medical expenses, but also promote the development of the whole health industry. Health propaganda has been given a new meaning of health management since then. Experts predict that health management will become a hot industry in the future^[2]As an emerging sunrise industry, its related industrial policies, investment prospects, theoretical research and practical operation have aroused many concerns and thinking.

Everyone knows that there is no health, just like 100 points are not preceded by 1, followed by 0, so for everyone, without health, there is no present and future.