Division of Non-communicable Diseases and Health Promotion, WHO Regional Office for Europe, Copenhagen, Denmark.
WHO Regional Office for Europe, Copenhagen, Denmark.
J Health Organ Manag. 2013;27(6):733-46. doi: 10.1108/JHOM-08-2011-0084.
The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each model to be effective, equitable, responsive and efficient.
DESIGN/METHODOLOGY/APPROACH: The authors used data from the WHO survey to identify organizational models. To produce a taxonomy of organizational models, three features of SHS organization were analyzed--the presence of health personnel specifically dedicated to school health services provision (school nurse and/or school doctor); the statutory involvement of other health professions in SHS provision; and the proximity of service provision to pupils (school-based or not school-based).
There are five organizational models of school health services in the Member States of the WHO European Region: dedicated school-based, dedicated community-based, integrated with primary care, mixed school-based, and mixed community-based. Preliminary reflections show that school based models are more likely to produce better outcomes in terms of effectiveness, equity, responsiveness, and efficiency.
RESEARCH LIMITATIONS/IMPLICATIONS: The WHO European Region has 53 Member States; the data are therefore incomplete and conclusions are limited to the 37 respondent countries.
Knowledge on performance of various models of service provision may inform decision-makers in the process of reforms.
ORIGINALITY/VALUE: This is the first attempt to produce a taxonomy of organizational models of school health services based on data from 37 countries, and to investigate the potential of each model to achieve desirable health system objectives.
本文旨在构建世卫组织欧洲区域学校卫生服务组织模式分类法，并就每种模式在实现有效性、公平性、回应性和效率方面的潜力进行思考。
设计/方法/途径：作者使用世卫组织调查数据来确定组织模式。为了构建组织模式分类法，分析了学校卫生服务组织的三个特征——是否存在专门提供学校卫生服务的卫生人员（学校护士和/或学校医生）；其他卫生专业人员是否参与学校卫生服务的提供；以及服务提供与学生的接近程度（是否在学校内提供）。
世卫组织欧洲区域成员国存在五种学校卫生服务组织模式：专门的校内模式、专门的社区模式、与初级保健整合模式、混合校内模式和混合社区模式。初步思考表明，基于学校的模式更有可能在效果、公平性、回应性和效率方面产生更好的结果。
研究局限性/影响：世卫组织欧洲区域有 53 个成员国；因此，数据不完整，结论仅限于 37 个答复国。
对各种服务提供模式绩效的了解可能为决策者在改革过程中提供信息。
原创性/价值：这是首次尝试根据来自 37 个国家的数据构建学校卫生服务组织模式分类法，并研究每种模式在实现理想卫生系统目标方面的潜力。
