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欧洲20个高收入国家医院中的一级预防——这是一个“未能充分利用每次接触机会”的案例吗?

Primary prevention in hospitals in 20 high-income countries in Europe - A case of not "Making Every Contact Count"?

作者信息

Rechel Bernd, Durvy Béatrice, Augusto Gonçalo Figueiredo, Aujoulat Isabelle, Behmane Daiga, Bensadon Anne-Carole, Burke Sara, D'Agostino Melissa, Davidovics Krisztina, Dayan Mark, De Belvis Antonio Giulio, de Jong Judith, Dubas-Jakóbczyk Katarzyna, Fronteira Inês, Gabriel Elena, Greco Giuseppe, Groenewegen Peter, Jervelund Signe Smith, Kantaris Marios, Kroneman Madelon, Farkas-Lainscak Jerneja, Maurice Benjamin, Conghail Luisne Mac, Murauskiene Liubove, Poldrugovac Mircha, Rákosy Zsuzsa, Scintee Silvia Gabriela, Sowada Christoph, Turblin Frédéric, Vankova Desislava, Velkey Zita, Vladescu Cristian, Vocanec Dorja, Vrangbæk Karsten, Wünscher Johannes, Ylitörmänen Tuija

机构信息

European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, United Kingdom.

European Observatory on Health Systems and Policies, Department of Health Care Management, Technical University of Berlin (TUB), Berlin, Germany.

出版信息

Health Policy. 2025 Jan;151:105199. doi: 10.1016/j.healthpol.2024.105199. Epub 2024 Nov 8.

Abstract

This article provides a snapshot of primary prevention activities in hospitals in 20 European high-income countries, based on inputs from experts of the Observatory's Health Systems and Policies Monitor (HSPM) network using a structured questionnaire. We found that in the vast majority of countries (15), there are no systematic national policies on primary prevention in hospitals. Five countries (Cyprus, Finland, Ireland, Romania and the United Kingdom) reported systematic primary prevention activities in hospitals, although in one of them (Cyprus) this was due to the fact that small hospitals in rural areas or less populated districts host providers of primary care. In two of the five countries with systematic national policies on primary prevention, there are no incentives (financial or otherwise) to provide these interventions. The remaining three countries (Finland, Romania and the United Kingdom) report the existence of incentives, but only two of them (Romania and the United Kingdom) provide financial incentives in the form of additional funding. Only two of the 20 countries (Ireland and the United Kingdom) make explicit use of the Making Every Contact Count (MECC) approach. Overall, it can be concluded that there is little focus on primary prevention in hospitals in Europe, which may be seen as a missed opportunity.

摘要

本文基于观测站卫生系统与政策监测(HSPM)网络专家通过结构化问卷提供的信息,呈现了20个欧洲高收入国家医院的一级预防活动概况。我们发现,绝大多数国家(15个)没有针对医院一级预防的系统性国家政策。五个国家(塞浦路斯、芬兰、爱尔兰、罗马尼亚和英国)报告了医院有系统性的一级预防活动,不过其中一个国家(塞浦路斯)是因为农村地区或人口较少地区的小医院提供初级保健服务。在有系统性国家一级预防政策的五个国家中,有两个国家没有提供这些干预措施的激励措施(财政或其他方面)。其余三个国家(芬兰、罗马尼亚和英国)报告有激励措施,但其中只有两个国家(罗马尼亚和英国)以额外资金的形式提供财政激励。20个国家中只有两个国家(爱尔兰和英国)明确采用了“每次接触都重要”(MECC)方法。总体而言,可以得出结论,欧洲医院对一级预防的关注很少,这可能被视为一个错失的机会。

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