van Herten L M, Gunning-Schepers L J
TNO Prevention and Health, PO Box 2215, 2301 CE, Leiden, The Netherlands.
Health Policy. 2000 Aug;53(1):1-11. doi: 10.1016/s0168-8510(00)00081-6.
This article reviews the start of the use of targets as a tool in health policy, summarises the fruitful uses and frequently-heard objections, and proposes some conditions for successful health target setting. Targets as tool in health policy are based on the 'management by objectives' approach (1954). The use in health policy was possible due to advances in the use of epidemiology for public health purposes. It provisionally ends with the new health targets adopted by WHO in 1998. The setting and monitoring of health targets is one way in which a government can provide leadership, guidance and strategic direction for the health sector. These benefits, and others, will also be reviewed. Drawbacks - such as political accountability and the limited malleability of society - will also be discussed. To overcome most of the objections, the article ends with some SMART conditions for successful health target setting: specific, measurable, achievable, realistic and time-bound. When SMART conditions are met, political will and daring are the recipe for a successful health target approach.
本文回顾了将目标作为卫生政策工具的起始情况，总结了其卓有成效的应用及常见的反对意见，并提出了成功设定卫生目标的一些条件。作为卫生政策工具的目标基于“目标管理”方法（1954年）。由于将流行病学用于公共卫生目的方面取得进展，其在卫生政策中的应用成为可能。本文暂时截止于世界卫生组织1998年采用的新卫生目标。设定和监测卫生目标是政府可为卫生部门提供领导、指导和战略方向的一种方式。这些益处及其他益处也将得到回顾。诸如政治问责制和社会可塑性有限等弊端也将进行讨论。为克服大多数反对意见，本文最后提出了成功设定卫生目标的一些SMART条件：具体、可衡量、可实现、现实和有时限。当满足SMART条件时，政治意愿和勇气是成功实施卫生目标方法的诀窍。
