Zácek A
Cesk Zdrav. 1989 Aug;37(8-9):335-41.
The finding that the health status of the population is shaped in particular by social and cultural conditions is accepted not only by health workers but also by political and executive authorities of the State. For the further development health care of the people is of revolutionary importance. If society will find adequate political will to take the appropriate measures, we may expect radical changes in all spheres of national economy, social life, science and culture. The basic demand is that health workers must acquire new sociomedical thinking which supplements and at the same time replaces the out-dated biomedical pattern. Structural changes will pertain in particular to mechanisms and organizational measures which will ensure the implementation of the health policy beyond the framework of the health services. In the system of health services we may anticipate that the centre of gravity in health care will shift from the traditional hospital to out-patient facilities with emphasis on the newly conceived function of primary health care. Training of health workers will have to be modified to the effect that graduates will be better prepared to meet actual needs of health care focused on prevention, economy, effectiveness and quality. It will be necessary to create favourable conditions for the development of socio-ecological, epidemiological and operational research. The democratization of health care will call for greater interest and initiative on the part of the public as regards collective and individual health. Our partial health projects should be re-arranged into a single comprehensive nation-wide programme which will include all spheres of health care in the sense of the WHO programme in its modification for Europe.
人们的健康状况尤其受到社会和文化条件影响这一发现,不仅被卫生工作者所接受,也被国家的政治和行政当局所认可。对人民医疗保健的进一步发展具有革命性意义。如果社会能找到足够的政治意愿来采取适当措施,我们有望在国民经济、社会生活、科学和文化的所有领域看到根本性变革。基本要求是卫生工作者必须获得新的社会医学思维,这种思维既能补充又能同时取代过时的生物医学模式。结构变革将尤其涉及机制和组织措施,这些措施将确保在卫生服务框架之外实施卫生政策。在卫生服务体系中,我们可以预期医疗保健的重心将从传统医院转向门诊设施,重点是新构想的初级卫生保健功能。卫生工作者的培训必须加以改进,使毕业生能更好地为满足以预防、经济、有效性和质量为重点的医疗保健实际需求做好准备。有必要为社会生态、流行病学和运筹学研究的发展创造有利条件。医疗保健的民主化将要求公众对集体和个人健康有更大的兴趣和主动性。我们的部分卫生项目应重新整合为一个单一的全国性综合项目,该项目将按照世界卫生组织针对欧洲的修改版计划涵盖医疗保健的所有领域。