An increasing number of health system researchers use systematic review to synthesize research evidence to inform the development of health policies at global and national levels. However, there are methodological challenges facing the health system research in undertaking systematic reviews of health policy literatures. This paper explored the constraints and promise of systematic review as a tool for evidence-based health system research in developing countries. It introduced the systematic review method and its evolution in health research over the past decades. The paper then discussed the definition of health system research, as system science, and contrasted its features/characteristics to those of medical research. It discussed and analyzed if the systematic review could be an effective tool for evidence-based health system research, particularly in developing countries. The paper concludes that the systematic review may be a very useful tool that can be used for evidence-based health system research to address specific policy issues; however, research on some health system/policy issues may not be appropriate to use the systematic review at all.
According to a guideline on promoting the high-quality development of public hospitals issued by the General Office of the State Council and a guideline on accelerating the development of medical rehabilitation, a high-quality and efficient rehabilitation system should be established, and efforts should be made to promote the high-quality development of rehabilitation services in public hospitals. We propose an action guideline for promoting the high-quality development of rehabilitation services in public hospitals, which is based on a Delphi method questionnaire on the opinions of front-line clinical rehabilitation experts, and integrated with relevant literature and evidences. This guideline introduces 31 specific action plans from 7 dimensions, including standardization of basic rehabilitation settings, standardization of clinical rehabilitation techniques, improvement of the tertiary rehabilitation system, standardization of emergency rehabilitation, standardization of rehabilitation education, standardization of rehabilitation management, and promotion of scientific and technological innovation in rehabilitation medicine.
Under the background of high-quality development of public hospitals and from the perspective of medical technology management, this paper discusses the high-quality development path of medical technology management in West China Hospital, Sichuan University. By sorting out the development context of restricted medical technology management in this medical institution, it concludes that there are four problems in restricted medical technology management at present: lack of standardized management system, non-unified surgery grading management, technology management information level to be improved, and the after-effect evaluation and transformation mechanism of medical technology being not perfect. It is proposed that establishing standardized management system, unifying surgical grading catalogue, constructing intelligent information system and establishing achievement transformation mechanism are important ways to strengthen medical technology management.
目的 了解近年四川省基层医疗卫生机构医疗服务的变化情况。 方法 对“四川省卫生统计数据采集与决策支持系统”收集的2002年－2011年年报数据进行分析。 结果 10年来，四川省基层医疗卫生机构医疗服务数量增加，效率提高，药费占医药费用的比例下降。 结论 10年卫生改革的有关政策特别是新医改的实施，对基层医疗卫生机构医疗服务起到较大的推动作用，四川省“保基本，强基层”的战略目标正在逐步实现。
Since the 13th Five-Year Plan proposed to practice capacity building in pediatrics and promote rehabilitation of persons with disabilities, children’s rehabilitation in China has achieved large-scale and all-round development in medical care, education, and scientific research. These include the effective implementation of the children’s health program, the establishment of a basic public service system for children with disabilities, the building of a talent pool, and the continuous improvement of evidence-based research. However, there are still some problems such as insufficient total service resources, uneven distribution, shortage of high-quality resources and specialized talents, and lack of high-quality evidence-based evidence for featured technologies. Entering a new stage of development, we need to comprehensively improve the capacity of rehabilitation services for children, further standardize quality control, promote the spread and application of appropriate technologies, accelerate personnel training, promote the research, development, and implementation of new technologies, and improve the health of children throughout their life cycle.
Objective To investigate the current development status of chest wall surgery at all levels of hospitals in Sichuan Province, as well as to provide evidence for the promotion of chest wall surgery. Methods We conducted a questionnaire study to investigate chest wall surgery at all levels of hospitals in Sichuan Province and to collect suggestions for chest wall surgery development from thoracic surgeons attending the meeting of the Sichuan International Medical Exchange & Promotion Association from September 2021 to January 2022. Results A total of 128 questionnaires were issued, with 97 (75.8%) of them being valid. According to the survey results, hospitals with grade A secondary or higher in Sichuan Province performed chest wall surgery. Chest wall surgery accounted for 14.3% of thoracic surgery, with 70.4% being chest wall trauma surgeries, 11.6% being chest wall tumor surgeries, 10.5% being chest wall infection surgeries, and 7.5% being chest wall deformity surgeries. Chest wall surgery accounted for 9.3% of thoracic surgery in the grade A tertiary hospitals, primarily for chest wall trauma and tumor; 23.1% in grade B tertiary hospitals, primarily for chest wall trauma and tumor; and 50.7% in grade A secondary hospitals, primarily for chest wall trauma and infection. Totally 96.9% of hospitals supported the establishment of a subspecialty in chest wall surgery. Suggestions for advancing chest wall surgery included: enhancing communication and cooperation (e.g. holding academic conferences, training courses), the establishment of the chest wall surgery association or consortium, and the formulation of regulations and guidelines or consensus, etc. Conclusion Chest wall surgery has been performed at all levels of hospitals in Sichuan Province. The relevant guidelines can be made based on the related academic associations, thus boosting the development of chest wall surgery in the future.