低收入和中等收入国家 (L&MICs) 的卫生系统响应能力:重新审视其范围
Meesha Iqbal1, Robert Morgan2, Cici Bauer3
1Department of Management Policy and Community Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA meesha_jazz@hotmail.com.
BMJ open quality
|September 11, 2025
概括
为低收入和中等收入国家 (L&MICs) 制定了一项有效的卫生系统响应能力 (HSR) 框架. 这个由全球专家验证的10个领域框架有助于改善人口健康和加强卫生系统.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理
背景情况:
- 健康系统响应 (HSR) 对于满足非健康需求和改善人口健康至关重要.
- 确定特定的HSR领域对于低收入和中等收入国家 (L&MICs) 的有针对性的改进至关重要.
- 之前通过系统性文献审查开发了HSR的概念框架.
研究的目的:
- 验证卫生系统响应性 (HSR) 提出的概念框架.
- 通过使用Delphi过程的专家共识来完善HSR框架.
- 建立一个强大的HSR框架,用于L&MICs的应用.
主要方法:
- 进行了德尔菲进程,涉及13名全球卫生专家.
- 专家们根据科学实力,相关性和可行性对12个领域的53个子域进行了评级.
- 在保留子域和完成框架时,采用了共识标准.
主要成果:
- 已验证的HSR框架包括10个域和31个子域.
- 关键领域包括尊重尊严,设施质量,社会支持,提供者选择,快速获取,沟通,财务保护和护理协调.
- 在科学强度,相关性和可行性评估方面实现了高内部一致性 (克朗巴赫α>0.93).
结论:
- 开发的10个领域的HSR框架被推用于L&MICs.
- 在广泛实施之前,建议在特定情况下预测框架.
- 这种经过验证的框架可以指导努力提高卫生系统的响应能力和人口健康结果.
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