Roos N P
Manitoba Centre for Health Policy and Evaluation, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Med Care. 1995 Dec;33(12 Suppl):DS132-45.
This article discusses the lessons learned from the experience of designing and using a population health information system and the policy implications of information generated. A useful system must include measures of the population's health status and socioeconomic risk when analyzing health care use. The strong gradient that can be demonstrated in service use across income groups where these indicators are included challenges policymakers and health care managers to rethink fundamental beliefs about the role of medical care. Given the size of health care expenditures in western economies, the author argues for redirecting some of these resources toward other means of improving the health of populations. Outcomes research should be expanded to assess the efficacy of non-medical and medical interventions. A population-based health information system can help identify opportunities for shifting expenditures toward meliorating the determinants of health, while monitoring the health care system to ensure that adverse effects do not occur.
本文讨论了从设计和使用人口健康信息系统的经验中吸取的教训以及所产生信息的政策影响。一个有用的系统在分析医疗保健使用情况时必须包括人口健康状况和社会经济风险的衡量指标。在纳入这些指标的情况下，不同收入群体在服务使用方面呈现出的强烈梯度，促使政策制定者和医疗保健管理者重新思考关于医疗保健作用的基本信念。鉴于西方经济体医疗保健支出的规模，作者主张将其中一些资源重新导向其他改善人口健康的途径。应扩大结果研究以评估非医疗和医疗干预措施的效果。基于人口的健康信息系统有助于确定将支出转向改善健康决定因素的机会，同时监测医疗保健系统以确保不会产生不良影响。
