摘要
背景:通过加强卫生人力留用以提高偏远和农村地区卫生人力的可及性,对于人口健康至关重要。然而,此类干预措施有关成本方面的信息往往零散、不全面、甚至缺失。政策措施的成本分析对于政策的选择、规划、实施和评估至关重要,但是由于缺少成本分析的系统方法,为卫生政策制定和决策带来了严峻的挑战。方法:本文提出了提高偏远及农村地区卫生人力可及性政策干预措施的成本分析实施框架,旨在为卫生政策决策者提供帮助。同时,该框架也强调了确定财政的主要来源和财政资金可持续性的重要性。文章对加强边远农村地区卫生人力留用相关政策措施的成本分析进行了文献综述,为此类干预措施的成本分析提供了指导框架,并进一步调查分析了成本分析在整个卫生人力规划与管理中的角色与重要意义。结果:尽管对于人力留用相关政策措施效益的争论得到越来越多的关注,但如何对此类政策措施进行成本分析,目前仍缺乏相关的知识与证据。为了解决这个问题,文章提出了实施成本分析框架的关键要素,并对此进行讨论分析。结论:这些关键要素能够帮助决策者对政策措施有更加深入的了解,明晰与理解财政来源和运行机制,同时确保财政资金的可持续性。
Background： Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning , implementation and evaluation of these policies. This lack of systematic approach to costing poses a serious challenge for strong health policy decisions. Methods： This paper proposes a framework for carrying out a costing analysis of interventions to increasing the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and assessing financial sustainability. The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning an management. Results ： We show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of framework to undertake a cost analysis are proposed and discussed. Conclusions： These key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.
出处
《中国卫生政策研究》
2011年第12期10-17,共8页
Chinese Journal of Health Policy
关键词
卫生人力资源
偏远及农村地区
留用
成本分析
技术框架
Human resources for health
Remote and rural areas
Retention
Cost analysis
Technical framework
