Mechanic D
Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA.
Soc Sci Med. 1999 Mar;48(6):711-8. doi: 10.1016/s0277-9536(98)00399-2.
Policymakers in many countries seek to contain health care costs over the long range by promoting health and more effective health behavior. Such efforts can be directed at entire populations, at members of a health plan, at defined risk groups or single individuals at risk. Many health risks are associated with socio-economic status and social inequalities but these are often difficult to address because of social and political conflicts. Health, also, is often a product of culture and other social circumstances. Health may be promoted through non-health interventions or through more targeted health efforts seeking to effect behavior change. Preventive screening is of growing importance but such efforts often out-pace evidence of efficacy or cost-effectiveness. Many opportunities exist to build on new clinician-patient partnerships to make patients better informed and to effect positive health behavior. New technologies, and particularly the internet, offer new ways to promote health and more constructive illness behaviors.
许多国家的政策制定者试图通过促进健康和更有效的健康行为来长期控制医疗保健成本。这些努力可以针对全体人群、健康计划的成员、特定风险群体或有风险的个体。许多健康风险与社会经济地位和社会不平等有关，但由于社会和政治冲突，这些问题往往难以解决。健康也是文化和其他社会环境的产物。可以通过非健康干预措施或通过更有针对性的健康努力来促进健康，这些努力旨在实现行为改变。预防性筛查越来越重要，但此类努力往往超过了疗效或成本效益的证据。有很多机会可以建立新的临床医生与患者的伙伴关系，使患者了解更多信息并实现积极的健康行为。新技术，尤其是互联网，提供了促进健康和更具建设性的疾病行为的新方法。
