摘要
我国卫生健康事业进入新发展阶段,仍面临资源分布不均、体系协同不足等挑战,提升卫生健康体系自身发现问题和解决问题的能力是关键;学习型卫生健康体系理念的研究与应用,将在提升循证决策和精准施策水平、改进风险防控和疾病诊疗质量方面发挥重要作用。本文总结了学习型卫生健康体系的理念特征和应用场景,阐述了国内外在数据分析、证据应用闭环方面的理念完善情况,以及在医疗质量评价、医疗质量改进等方面的应用进展;立足我国卫生健康体系的特征与现状,从提升能力、补强资源、建设平台、推进研究等方面讨论了学习型卫生健康体系构建的基础要素与实施路径,研判了行政数据在医疗质量评价中的应用、“互联网+”应用于医疗质量改进两类实践成效。展望未来,可在技术创新、领域拓展两方面深化学习型卫生健康体系建设,提升数据治理、分析决策、证据推广、监测反馈等环节的质量及效率,增强以学习型疾病监测为代表的卫生健康领域决策管理能力。
The health system in China has progressed to a new phase of development;however,it continues to face challenges such as uneven distribution of resources and insufficient coordination among service sectors.It is imperative to enhance the health system’s intrinsic capacity to identify and address problems.The research and implementation of the learning health system(LHS)concept are expected to play a pivotal role in promoting evidence-based policy formulation and implementation,as well as improving preventive services and clinical care.This study offers a comprehensive overview of the conceptual characteristics and application contexts of LHS.It outlines both domestic and international advancements in refining data analysis and the evidence application cycle,and reviews progress in practical applications,including quality measurement and improvement of care.Drawing upon the features and current status of China’s health system,the study discusses foundational components and implementation strategies for establishing an LHS.These strategies emphasize strengthening the research capacity of leading institutions and the application capacity of professionals;enhancing data resources from hospitals,health administration,and health insurance;developing technological platforms for data acquisition,governance,utilization,and sharing;and conducting outcomes research and implementation research.Furthermore,the study evaluates the practical outcomes of two initiatives:the use of administrative data for quality measurement of care and the integration of Internet Plus in quality improvement of care.Looking ahead,the development of LHSs can be further advanced through the application of novel technologies and expansion into new domains.Such progress is anticipated to enhance the quality and efficiency of data governance,analysis,decision-making,evidence dissemination,and feedback monitoring,as well as to strengthen policy development and implementation,as exemplified by learning-based disease surveillance.
作者
李希
杨阳
苏明明
高仕君
金博林
胡盛寿
Li Xi;Yang Yang;Su Mingming;Gao Shijun;Jin Bolin;Hu Shengshou(National Center for Cardiovascular Diseases,Beijing 102308,China;Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)
出处
《中国工程科学》
北大核心
2025年第6期106-115,共10页
Strategic Study of CAE
基金
中国工程院咨询项目“中国老龄化过程中慢病发病现状、趋势和应对策略研究”(2022-ZCQ-10)。
关键词
学习型卫生健康体系
医疗质量评价
医疗质量改进
医疗数据
疾病监测
learning health system
quality measurement of care
quality improvement of care
medical data
disease surveillance
