2011年 · 第05卷第03期

As an important part of the health management discipline system, China's health examination industry is booming, the number of health examination institutions is increasing rapidly, and the market competition is becoming increasingly fierce. Health administrative departments and subjects pay increasing attention to the quality of health examination. In 2009, the Ministry of Health promulgated the Interim Regulations on the Administration of Health and Physical Examination, requiring health administrative departments and physical examination institutions at all levels to establish quality control systems and organizations^[1]。 In accordance with the form, Shanghai Municipal Health Bureau decided to establish Shanghai Health Examination Quality Control Center in March 2010, and determined the affiliated unit of the quality control center in the form of "fighting the ring". Since the establishment of the quality control center, by learning the quality control methods and means of other quality control centers in the region, and learning from the mature experience of physical examination quality control in brother provinces and cities, the establishment work has been successfully completed and the trial operation has started.

With the construction and development of the founding of the People's Republic of China in the past 60 years, especially the development of reform and opening up in the past 30 years, China has basically realized the first modernization (agricultural society to industrial society), began to enter the second modernization society, and entered the era of "emotional economy". The people's demand for hospitals and doctors is no longer simply "saving lives and helping the wounded, seeking medical advice", but "prolonging life, reducing pain and improving quality of life" has become a common and strong demand. At present, the vast majority of public hospitals that bring together China's top technology, talents and equipment are still in the stage of treating serious illnesses, and the treatment of difficult and complicated diseases is the standard for evaluating good hospitals. The development of society and people's demand for health determine that hospitals should undertake the responsibility of health management and disease management.

The burden of cervical cancer in China is heavy, and there is no systematic prevention and treatment plan for cervical cancer. In recent years, there is an increase in young cases in some areas^[1,2]。 Human papillomavirus (HPV) prophylactic vaccination has been shown to be effective in preventing HPV infection and can reduce the incidence of cervical cancer by about 70%, which provides a new prospect and direction for the prevention of cervical cancer^[3]。 This study aims to understand the cognition of HPV and the willingness to accept HPV vaccine among rural women in a county of Shanxi Province, analyze the potential obstacles to the popularization and application of HPV vaccine in rural areas of China, explore possible solutions, and provide reference materials for the primary prevention of cervical cancer in Chinese population.

The early detection and diagnosis of diabetes has been lacking of specific technical means. In recent years, important progress has been made in the early prediction and evaluation of the occurrence and development of diabetes mellitus by using convenient direct current induction technology in the world. The whole body health scanning test developed by French MS-TEK Company is a typical representative of this technology. We compared the whole body health scanning test with the traditional laboratory test, and the report is as follows.

With the rapid development of health management discipline, health (chronic disease) risk assessment based on health examination and basic lifestyle information has become an important link of chronic disease risk intervention and chronic disease management. From June 2009 to May 2010, the health examination department of our hospital used domestic health risk assessment software to conduct effective health (chronic disease) risk assessment of 1016 cases. The report is as follows:

With China's industrialization, urbanization, population aging and lifestyle transformation, chronic diseases have become the biggest threat to people's health and the main social and economic burden^[1]。 In the prevention and treatment of chronic diseases, there are phenomena of "emphasizing treatment over prevention" and "emphasizing drugs over management", which makes the main chronic diseases continue to spread. As one of the common chronic diseases of the respiratory tract, the incidence of pulmonary tuberculosis remains high in recent years. About 250,000 people die of tuberculosis in China every year. Because many patients with pulmonary tuberculosis lack common knowledge of tuberculosis prevention and treatment, treatment is often interrupted or the disease relapses^[2]。 Therefore, it is particularly important to carry out health education management for tuberculosis patients. The health education management and post-discharge guidance and follow-up results of hospitalized newly treated tuberculosis patients are summarized as follows:

At present, abortion has become a major public health problem affecting female reproductive health^[1]While the rate of re-selection and recommendation to others was significantly higher in medical abortion (mifepristone combined with misoprostol) than in surgical abortion^[2]。 Post-abortion services are an important component of quality reproductive health services and have become the mainstream in the field of reproductive health and family planning internationally^[3]。 China is gradually carrying out the pilot of high-quality family planning services. This study conducted consultation and health education for patients with medical abortion, aimed at exploring the intervention effect and effective mode, so as to improve the knowledge level of reproductive health and self-care awareness of patients with medical abortion, reduce the incidence of unintended pregnancy, and promote physical and mental health.

Health risk assessment refers to the quantitative assessment of the health status of an individual or group and the risk of future illness and/or death^[1]。 Health risk assessment of the population can better help the subjects understand their real health risks and guide them to change or modify unhealthy behaviors. We conducted physical examination and risk assessment on the enterprise managers who conducted physical examination in our center in 2009. The results of the examination and assessment are now reported as follows.

With the aging of China's social population, the prevalence of senile dementia is gradually increasing. Among the 130 million elderly, there are 10 million patients with dementia caused by various causes, including about 6 million senile dementia, with an annual new incidence rate of 1.2%^[1]。 Alzheimer's disease brings great mental suffering and financial burden to the elderly and their families, which seriously affects the quality of life. Therefore, it is of great significance to popularize the related knowledge of Alzheimer's disease in health education. Only when people know the disease, early detection, early diagnosis and early treatment can they delay the development of the disease and improve the quality of life of the elderly.

Hospice care is a kind of comprehensive health care service mainly aimed at the pain and many problems arising from the death process of dying patients, providing patients with comfortable medical environment, warm interpersonal relationship and strong spiritual support, helping patients to complete the last journey of life, and giving comfort and care to their families^[1]。 Hospice care, as an emerging marginal interdisciplinary subject in the medical field, has developed greatly in China in recent years. With the development trend of aging population structure in China, the elderly dying patients have become a special group of hospice care and have attracted more and more attention. The elderly are the main population of community health services. With the increasing number of elderly patients, the special demand for hospice care also increases accordingly. The present situation of community hospice care for the elderly in China is reviewed.

With the establishment of the new concept of health, the public demand for health is constantly expanding. As a new discipline, health management has only started in the world for more than 20 years and in China for less than 10 years, but its development has shown vigorous vitality. The advanced concept of health management has led and driven the rapid development of health industry^[1]。 At present, regular physical examination has become an indispensable healthy living habit for people from all walks of life in big cities. However, 80% of the population of our province is distributed in areas with underdeveloped medical and health resources below the county level, while 80% of medical and health resources are distributed in large and medium-sized cities. The development of medical and health care level is unbalanced^[2]Tertiary hospitals and high, sophisticated and cutting-edge medical equipment are mostly distributed in big cities. Even in big cities, physical examination customers want to go to tertiary hospitals for physical examination, which increases the burden on municipal hospitals, while grassroots health examination resources are under-utilized. Physical examination customers in remote areas have to go to higher-level hospitals for physical examination due to the backward local medical conditions. In this way, the transportation expenses and physical examination fees to other places increase the financial burden on customers. Moreover, some medical conditions are backward, and some people in health need often go to higher-level hospitals for health examination and disease consultation, which not only delays diagnosis and treatment, but also aggravates the financial burden of patients and their families. Therefore, it is of practical significance to establish a new digital visual remote health management platform (hereinafter referred to as "the new platform"). This paper discusses the development status of the new platform at home and abroad, the development status and significance of our hospital.

Under the new medical reform situation, the state has put forward the medical policy and strategy of "moving the checkpoint forward and moving the center of gravity down" and focusing on prevention. It is imperative for general hospitals to carry out health examination and health management services. The health examination institution of our hospital was established in 2007, based on health examination, focusing on health management, strengthening standardized management, connotation construction, innovative services, etc., and establishing and improving the health service mode of general hospitals, which is summarized as follows.

The World Health Organization (WHO) puts forward the slogan of health care for all and health equity in the 21st century, and emphasizes that in the new century, medicine should focus on human health instead of disease as its main research field. Medical service is in the transition period from therapeutic medicine to nursing medicine. We should implement the concept of health management in medical education and train medical staff who have health management consciousness and can meet the health needs of people.

The definition of passive smoking adopts the World Health Organization definition of passive smoking, that is, non-smokers, who have at least 1 day per week and inhale smoke exhaled by smokers for more than 15 minutes^[1]。 Numerous studies on passive smoking in pregnant women have shown that passive smoking in pregnant women not only harms their own health, but also affects embryonic development^[2]Can reduce the average birth weight of newborns, increase the incidence of low birth weight and smaller than gestational age, and increase the risk of premature birth, spontaneous abortion or stillbirth of the fetus^[3,4]。 In order to understand the situation, knowledge, psychological state, attitude and behavior of non-smoking pregnant women exposed to second-hand smoke in Black Sand Ring, Macao, and to provide scientific basis for formulating policies to protect pregnant women from second-hand smoke.

With the transformation of modern medical model, the ethical and moral problems in medicine have attracted more and more attention. Health management is an emerging and rapidly developing subject, but the related ethical issues have not been discussed on a large scale. Analyzing and thinking about all aspects of health management from the perspective of ethics is not only helpful to strengthen the ethical concept of health management institutions and carry out humanized health management services, but also conducive to the communication between health management institutions and management objects, and can improve the effect of health management.

Since the late 1990s, health management has been quietly rising and developing rapidly in China, and has achieved remarkable results^[1]。 Especially after the promulgation of the National Basic Public Health Service Standards (2009 Edition), community health management services have been standardized to a certain extent^[2]。 However, at present, health management in China is still in the initial stage of development, and there are many fundamental problems that affect service quality to be solved urgently, such as: the theoretical research is relatively lagging behind, the complete medical service model has not yet been formed, and the lack of systematic service norms. On the basis of learning from foreign advanced health management service models, this study puts forward a new health management service mode suitable for China's national conditions, so as to improve the quality of health management service, and provide reference for the theory and practice of health management in China.

In recent years, people's demand for health has begun to enter the era of health management. Health management is the medical behavior and process of comprehensively detecting, evaluating, effectively intervening and continuously tracking the overall health status of individuals or groups and the risk factors affecting health by adopting the theories, techniques, methods and means of modern medicine and modern management^[1]。 Health management needs to record the service content and process of each customer, as well as the health information collected and generated during the service process, and these records form the health management file.

Health management has been widely carried out in many medical institutions, but in reality, especially in the vast number of primary hospitals, both the medical staff who implement health management and the people who accept health management are limited in understanding the deep connotation of health management and low participation, so that health management is reflected in more aspects by "collective physical examination and physical examination results evaluation and limited consultation and guidance", which is largely different from the standardized and effective health management connotation requirements. In many years of work practice, we believe that: to implement effective health management, it is necessary to completely change the service concept of medical staff, carry out extensive health education inside and outside the hospital on the premise of doing a good job in daily medical work, and guide more people to establish health care awareness is the "key"; The "foundation" of effective health management can be laid only by wider popularization of health science knowledge among the general public and recognition of the importance of preventive health care.

Entrusted by the editorial department of Chinese Journal of Health Management, I had an exclusive telephone interview with Dr. Stephen Barrie, a world-renowned functional medicine doctor. Stephen Borui began to devote himself to comprehensive medical research in 1980. In 1986, he founded Great Smokies Functional Medicine Laboratory (now Genova Diagnostics, the largest functional medicine testing center in the United States), which is mainly dedicated to the research of early intervention medical care model of natural therapy, and developed methods for detecting the cause of chronic degenerative diseases; In the early 1990s, he participated in the creation of the American College of Functional Medicine. Dr. Borui is called "an epoch-making interventionist in the field of personalized medicine" by the medical community. Stephen Borui is a visiting professor at the Royal College of Internal Medicine in London, has published a large number of scientific papers, and is the founder of many well-known nutritional products in the United States. The best-selling author of health books in the New York Times and Los Angeles Times, with his masterpieces "7 Day Detox Miracle", "Energize Your Life", etc.

At present, lifestyle-related diseases such as diabetes, hypertension, and dyslipidemia are increasingly prevalent. It is very important to educate the general population to change their bad lifestyle and prevent the onset of healthy people, which is also in line with the concept of preventing first and treating the disease before it is treated by a doctor. Therefore, more and more attention is paid to health education^[1,2]And is in full swing all over the country. However, how to improve the practical effect of health education is an important issue that needs to be solved urgently. As a member of the grass-roots county and city health education lecturer group and the democratic party health education lecturer group, in recent years, I have been lucky enough to participate in dozens of health education sessions for the general public, including mountainous islands and large enterprises such as Huabin and Huafeng, and have gained good response and good results. Talk about personal feelings and experience, hope to share with you.