Climate change adaptation is the process of preparing and actively adjusting to meet the climate change (negative effects and potential opportunities). Urban adaptation is aimed at the sensitivity level of risks and s...Climate change adaptation is the process of preparing and actively adjusting to meet the climate change (negative effects and potential opportunities). Urban adaptation is aimed at the sensitivity level of risks and specific impacts of cities under the impact of climate change, and to develop policies and investment programs to reduce the vulnerability of cities to climate change risk. Urban adaptive action provides the basis and direction for the construction of urban resilience and sustainable development. Identifying the demand of adaption technologies, promoting the practical implementation of international technology transfer and reducing domestic emissions have important significance for the global response to climate change and improvement of the ability of urban adaptation. In this paper, through in-depth analysis on the concept and connotation of climate change, climate disasters and urban adaptation to climate change, the evaluation framework and steps of urban adaptation to climate change technology are determined, and six priority application technologies which can maximize the overall efficiency of sustainable development, improve the ability to adapt to climate change and at the same time reduce the cost at the greatest extent are identified.展开更多
本文基于英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布的《真实世界证据框架》,探讨其方法论创新及对我国医保准入决策的启示。在全球医保治理迈向价值驱动的背景下,真实世界证据(Real W...本文基于英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布的《真实世界证据框架》,探讨其方法论创新及对我国医保准入决策的启示。在全球医保治理迈向价值驱动的背景下,真实世界证据(Real World Evidence,RWE)已成为弥补随机对照试验局限、支撑医保精准购买的关键工具,其科学生成与规范应用至关重要。NICE框架以透明性、数据适用性与方法严谨性为三大支柱,系统构建了RWE的应用体系:通过倡导“目标试验模拟”来增强观察性研究的因果推断效力,并整合定性证据,以全面评估患者体验与临床实施路径。实践表明,该框架在癌症、数字疗法及罕见病等领域的评估中成效显著。我国正处于真实世界医保价值评价探索期,鉴于此,可重点从夯实数据治理基础、规范方法学标准、明晰实施路径三个维度着手,构建符合国情的本土化RWE应用体系。展开更多
健康公平性是全球卫生治理的核心议题,但传统卫生技术评估(health technology assessment,HTA)框架长期以效率为导向,未能充分纳入公平性考量,可能加剧系统性健康不平等。本文系统梳理健康公平性的核心概念,整合国际主流评价框架,分析...健康公平性是全球卫生治理的核心议题,但传统卫生技术评估(health technology assessment,HTA)框架长期以效率为导向,未能充分纳入公平性考量,可能加剧系统性健康不平等。本文系统梳理健康公平性的核心概念,整合国际主流评价框架,分析其方法论特点及适用场景。现有健康公平性评价框架在目标定位和方法侧重上存在显著差异,HTA公平性检查清单(the Equity Checklist for Health Technology Assessment,ECHTA)通过分阶段清单嵌入公平性分析,但实施复杂程度较高;《卫生保健优先事项设定指南》(Guidance on Priority Setting in Health Care,GPS-Health)侧重多维公平标准,适合资源有限地区;美国临床和经济审查研究所(Institute for Clinical and Economic Review,ICER)框架强调患者参与及亚组分析,需高质量数据支撑;国际药物经济学与结果研究学会(International Society for Pharmacoeconomics and Outcomes Research,ISPOR)框架以数据驱动为核心,依赖纵向证据。针对我国尚未构建HTA健康公平性评价框架的现状,提出本土化实施路径,融合ECHTA流程与GPS-Health定性标准,结合分布式成本效果分析方法及亚组识别,构建“定性-定量”混合评价体系,同步推进健康差异基线数据库建设,为构建以健康公平为导向的卫生治理体系提供参考,助力破解效率与公平的结构性矛盾,促进全民健康覆盖目标实现。展开更多
文摘Climate change adaptation is the process of preparing and actively adjusting to meet the climate change (negative effects and potential opportunities). Urban adaptation is aimed at the sensitivity level of risks and specific impacts of cities under the impact of climate change, and to develop policies and investment programs to reduce the vulnerability of cities to climate change risk. Urban adaptive action provides the basis and direction for the construction of urban resilience and sustainable development. Identifying the demand of adaption technologies, promoting the practical implementation of international technology transfer and reducing domestic emissions have important significance for the global response to climate change and improvement of the ability of urban adaptation. In this paper, through in-depth analysis on the concept and connotation of climate change, climate disasters and urban adaptation to climate change, the evaluation framework and steps of urban adaptation to climate change technology are determined, and six priority application technologies which can maximize the overall efficiency of sustainable development, improve the ability to adapt to climate change and at the same time reduce the cost at the greatest extent are identified.
文摘本文基于英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布的《真实世界证据框架》,探讨其方法论创新及对我国医保准入决策的启示。在全球医保治理迈向价值驱动的背景下,真实世界证据(Real World Evidence,RWE)已成为弥补随机对照试验局限、支撑医保精准购买的关键工具,其科学生成与规范应用至关重要。NICE框架以透明性、数据适用性与方法严谨性为三大支柱,系统构建了RWE的应用体系:通过倡导“目标试验模拟”来增强观察性研究的因果推断效力,并整合定性证据,以全面评估患者体验与临床实施路径。实践表明,该框架在癌症、数字疗法及罕见病等领域的评估中成效显著。我国正处于真实世界医保价值评价探索期,鉴于此,可重点从夯实数据治理基础、规范方法学标准、明晰实施路径三个维度着手,构建符合国情的本土化RWE应用体系。
文摘健康公平性是全球卫生治理的核心议题,但传统卫生技术评估(health technology assessment,HTA)框架长期以效率为导向,未能充分纳入公平性考量,可能加剧系统性健康不平等。本文系统梳理健康公平性的核心概念,整合国际主流评价框架,分析其方法论特点及适用场景。现有健康公平性评价框架在目标定位和方法侧重上存在显著差异,HTA公平性检查清单(the Equity Checklist for Health Technology Assessment,ECHTA)通过分阶段清单嵌入公平性分析,但实施复杂程度较高;《卫生保健优先事项设定指南》(Guidance on Priority Setting in Health Care,GPS-Health)侧重多维公平标准,适合资源有限地区;美国临床和经济审查研究所(Institute for Clinical and Economic Review,ICER)框架强调患者参与及亚组分析,需高质量数据支撑;国际药物经济学与结果研究学会(International Society for Pharmacoeconomics and Outcomes Research,ISPOR)框架以数据驱动为核心,依赖纵向证据。针对我国尚未构建HTA健康公平性评价框架的现状,提出本土化实施路径,融合ECHTA流程与GPS-Health定性标准,结合分布式成本效果分析方法及亚组识别,构建“定性-定量”混合评价体系,同步推进健康差异基线数据库建设,为构建以健康公平为导向的卫生治理体系提供参考,助力破解效率与公平的结构性矛盾,促进全民健康覆盖目标实现。
