上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2023 , Vol. 43 >Issue 2: 137 - 142

DOI: https://doi.org/10.3969/j.issn.1674-8115.2023.02.001

前沿述评

基于主动健康指数的数字化慢性病防控的思考与探索

  • 高翔 ,
  • 李晓光 ,
  • 周良 ,
  • 王慧
展开
  • 上海交通大学公共卫生学院，上海 200025
高 翔（1987—），男，博士；电子信箱：xianggao@shsmu.edu.cn。
王 慧，电子信箱：huiwang@shsmu.edu.cn。

收稿日期: 2022-12-27

  录用日期: 2023-01-19

  网络出版日期: 2023-02-28

基金资助

国家重点研发计划(2018YFC2000700);国家自然科学基金(82030099)

收起

Reflection and exploration of digital chronic disease management based on the proactive health index

  • Xiang GAO ,
  • Xiaoguang LI ,
  • Liang ZHOU ,
  • Hui WANG
Expand
  • School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
WANG Hui, E-mail: huiwang@shsmu.edu.cn.

Received date: 2022-12-27

  Accepted date: 2023-01-19

  Online published: 2023-02-28

Supported by

National Key R&D Program of China(2018YFC2000700);National Natural Science Foundation of China(82030099)

Fold

摘要

慢性非传染性疾病（以下简称“慢性病”）导致的疾病负担仍在不断增加，深刻地影响着公众健康和社会经济发展。传统的慢性病健康管理，缺乏诊断标准和健康干预的合理介入时机，且需方主动性缺失的瓶颈日益凸显。将健康主动性概念引入并构建主动健康指数（proactive health index，PHI），有望成为优化慢性病健康管理的有效手段。随着全球进入数字化变革的关键时期，我国健康战略已明确维护和保障人民健康应发挥科技创新和信息化的引领支撑作用，数字健康为慢性病健康管理的发展带来战略机遇。该文在数字化慢性病防控的发展背景下，分析我国慢性病健康管理当前存在的主要瓶颈，明确构建慢性病健康管理诊断标准的重要性，提出PHI的概念及构建以解决慢性病健康管理的关键问题，并从政府端、家庭医生端和公众端对PHI的应用场景进行了部署与展望，以期为提升居民健康管理主动性，优化慢性病健康管理的效果提供思路。

关键词： 主动健康指数; 数字健康; 健康管理; 慢性病

本文引用格式

高翔 , 李晓光 , 周良 , 王慧 . 基于主动健康指数的数字化慢性病防控的思考与探索[J]. 上海交通大学学报（医学版）, 2023 , 43(2) : 137 -142 . DOI: 10.3969/j.issn.1674-8115.2023.02.001

Abstract

The disease burden caused by chronic non-communicable diseases continues to grow, with profound implications for public health and socio-economic development. The traditional health management of chronic diseases lacks diagnostic criteria and reasonable intervention time, and the bottleneck of the lack of residents' initiative is increasingly prominent. The construction of proactive health index (PHI) is expected to be an effective means to improve the health management of chronic diseases. As the world enters a critical period of digital transformation, China's health strategy has made clear that technological innovation and information technology should play a leading role in maintaining people's health, and digital health brings strategic opportunities for the development of chronic disease health management. In the context of the development of digital chronic disease prevention and control, this study analyzes the main bottlenecks existing in China's chronic disease health management, clarifies the importance of establishing diagnostic criteria for chronic disease health management, proposes the concept of PHI, and introduces the construction of PHI to solve the key problems of chronic disease health management. The application scenarios of PHI are deployed and prospected from the government side, the family physician side and the public side, in order to provide ideas for improving residents' health management initiative and enhancing the effectiveness of chronic disease health management.

Key words： proactive health index; digital health; health management; chronic disease

参考文献

1 World Health Organization. Noncommunicable diseases[EB/OL]. (2021-09-16) [2022-01-14]. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
2 BAMBRA C, RIORDAN R, FORD J, et al. The COVID-19 pandemic and health inequalities[J]. J Epidemiol Community Health, 2020, 74(11): 964-968.
3 GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990—2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204-1222.
4 国务院新闻办公室. 国务院新闻办就《中国居民营养与慢性病状况报告(2020年)》有关情况举行发布会[EB/OL]. (2020-12-24) [2022-01-15].http://www.gov.cn/xinwen/2020-12/24/content_5572983.htm.
4 The Information Office of the State Council. The Information Office of the State Council held a press conference on the Report on the Status of Nutrition and Chronic Diseases of Chinese Residents (2020) [EB/OL]. (2020-12-24) [2022-01-15]. http://www.gov.cn/xinwen/2020-12/24/content_5572983.htm.
5 GBD 2019 Viewpoint Collaborators. Five insights from the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1135-1159.
6 GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990—2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1223-1249.
7 中共中央国务院. 中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL]. (2016-10-25) [2022-01-25]. http://www.gov.cn/gongbao/content/2016/content_5133024.htm.
7 The State Council. The State Council issued the Outline of the Healthy China 2030 Plan[EB/OL]. (2016-10-25) [2022-01-25]. http://www.gov.cn/gongbao/content/2016/content_5133024.htm.
8 RODRIGUEZ J A, SHACHAR C, BATES D W. Digital inclusion as health care: supporting health care equity with digital-infrastructure initiatives[J]. N Engl J Med, 2022, 386(12): 1101-1103.
9 VAYENA E. Value from health data: European opportunity to catalyse progress in digital health[J]. Lancet, 2021, 397(10275): 652-653.
10 叶恬恬, 赵允伍, 王晓松, 等. 基于“主动健康”理念的社区慢性病管理模式研究[J]. 卫生经济研究, 2021, 38(8): 45-48.
10 YE T T, ZHAO Y W, WANG X S, et al. Research on community chronic disease management model based on the concept of "active health"[J]. Health Economics Research, 2021, 38(8): 45-48.
11 DE JONG C, VAN BOVEN J F M, DE BOER M R, et al. Improved health status of severe COPD patients after being included in an integrated primary care service: a prospective cohort study[J]. Eur J Gen Pract, 2022, 28(1): 66-74.
12 吴家睿. 实施主动健康战略面临的主要挑战[J]. 生命科学, 2022, 34(3): 229-233.
12 WU J R. Main challenges in implementing the active health strategy[J]. Chinese Bulletin of Life Sciences, 2022, 34(3): 229-233.
13 张倩倩, 金花, 史晓晓, 等. 我国主动健康的实施现状及对各责任主体实施策略的建议[J]. 中国全科医学, 2022, 25(31): 3923-3927, 3932.
13 ZHANG Q Q, JIN H, SHI S S, et al. Proactive care in China: implementation status and recommendation strategies for various undertaking bodies [J]. Chinese General Practice, 2022, 25(31): 3923-3927, 3932.
14 付强强, 金花, 李丽, 等. 主动健康视角下健康素养测评工具的研究现状及其对我国的启示[J]. 中国全科医学, 2022, 25(31): 3933-3943.
14 FU Q Q, JIN H, LI L, et al. Research status of health literacy assessment tools from the perspective of active health and its enlightenment to China[J]. Chinese General Practice, 2022, 25(31): 3933-3943.
15 黎婉钰, 金花, 于德华. 基于社区卫生服务机构的主动健康实施策略[J]. 中国全科医学, 2022, 25(31): 3928-3932.
15 LI W Y, JIN H, YU D H. Implementation strategies of community-based proactive care management[J]. Chinese General Practice, 2022, 25 (31): 3928-3932.
16 殷志坚. 诊断标准的应用[J]. 临床荟萃, 1988, 3(2): 65-67.
16 YIN Z J. Application of diagnostic criteria[J]. Clinical Focus, 1988, 3(2): 65-67.
17 CHEN C, GONG X, WANG X L, et al. Evaluation of the implementation and effect of the healthcare cloud information platform for diabetes self-management: a case study in Shanghai[J]. Int J Health Plann Manage, 2019, 34(3): 986-997.
18 弓孟春, 刘莉, 王媛媛, 等. 主动健康管理模式的构建策略[J]. 科技导报, 2022, 40(6): 93-100.
18 GONG M C, LIU L, WANG Y Y, et al. Construction strategy of proactive health management model [J]. Science & Technology Review, 2022, 40 (6): 93-100.
19 傅玲玲, 谭秋生, 茅晓风. “主动健康”视域下医学科普的实践与思考[J]. 中华健康管理学杂志, 2022, 16(1): 66-68.
19 FU L L, TAN Q S, MAO X F. Practice and thinking of medical science popularization from the perspective of "active health"[J]. Chinese Journal of Health Management, 2022, 16(1): 66-68.
20 BENTHIEN K S, RASMUSSEN K, NIELSEN C P, et al. Proactive Health Support: a randomised controlled trial of telephone-based self-management support for persons at risk of hospital admission[J]. Age Ageing, 2022, 51(10): afac212.
21 WALDMAN S A, TERZIC A. Health care evolves from reactive to proactive[J]. Clin Pharmacol Ther, 2019, 105(1): 10-13.
22 国务院.国务院关于印发“十三五”国家科技创新规划的通知[EB/OL]. (2016-07-28) [2022-05-07]. http://www.gov.cn/zhengce/content/2016-08/08/content_5098072.htm.
22 The State Council. Circular of the State Council on Printing and Distributing the National Scientific and Technological Innovation Plan for the 13th Five-Year Plan[EB/OL]. (2016-07-28) [2022-05-07]. http://www.gov.cn/zhengce/content/2016-08/08/content_5098072. htm.
23 LIU J, LI W D, YAO H Y, et al. Proactive health: an imperative to achieve the goal of healthy China[J]. China CDC Wkly, 2022, 4(36): 799-801.
24 高翔, 谭硕源, 李晓光, 等. 社区居民健康管理困境分析与基于主动健康指数的应对策略[J].中华全科医师杂志, 2023, 22(1): 24-28.
24 GAO X, TAN S Y, LI X G, et al. Dilemma analysis of health management among community residents and countermeasures based on the proactive health index[J]. Chinese Journal of General Practitioners, 2023, 22(1): 24-28.
25 ROTHMAN K, KELLER A. The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx[J]. J Chronic Dis, 1972, 25(12): 711-716.
26 CHEN T Q, GUESTRIN C. XGBoost: a scalable tree boosting system[C]//Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining. August 13?17, 2016, San Francisco, California, USA. New York: Association for Computing Machinery, 2016: 785-794.
27 朱俊峰. 中国地方政府绩效评估研究: 基于广义模糊综合评价模型的分析[D]. 上海: 上海交通大学, 2011.
27 ZHU J F. Research on performance evaluation of local governments in China: analysis based on generalized fuzzy comprehensive evaluation model[D]. Shanghai: Shanghai Jiao Tong University, 2011.
28 BARTHOLOMEW L K, PARCEL G S, KOK G. Intervention mapping: a process for developing theory- and evidence-based health education programs[J]. Health Educ Behav, 1998, 25(5): 545-563.
29 袁玲, 高翔, 李晓光, 等. 全科应用场景下机器学习为健康风险评估赋能[J]. 中华全科医师杂志, 2023, 22(1): 19-23.
29 YUAN L, GAO X, LI X G, et al. Machine learning empowers health risk assessment in general practice application scenarios[J]. Chinese Journal of General Practitioners, 2023, 22(1): 19-23.
30 国务院. 国务院办公厅关于印发“十四五”国民健康规划的通知[EB/OL]. (2022-04-27) [2022-05-07]. http://www.gov.cn/zhengce/zhengceku/2022-05/20/content_5691424.htm.
30 The State Council. Notice of the General Office of the State Council on Printing and Distributing the 14th Five-Year National Health Plan[EB/OL]. (2022-04-27) [2022-05-07]. http://www.gov.cn/zhengce/zhengceku/2022-05/20/content_5691424.htm.
Options
文章导航

/

〈 〉