Current Status Of Evidence-informed Health Decision-making And The Establishment Of Priority Issue In The Evidence-informed Health Decision-making Network

BackgroudLinking research to action in the health sector has recently captured a great deal of international attention. In November, 2004, 20 ministers of health and senior policymakers from 52 countries met in Mexico to discuss how research can help them in their daunting task to develop and implement effective health policies. May 2005 the World Health Assembly issued a resolution calling on WHO member states to "establish or strengthen mechanisms to transfer knowledge in support of evidence-based public health and healthcare delivery systems, and evidence-based health-related policies and calling on WHO's Director General to "assist in the development of more effective mechanisms to bridge the divide between ways in which knowledge is generated and ways in which it is used, including the transformation of health-research findings into policy and practice." Thie efforts will support health decision-making and health policy formulation in low-income and middle-income countries. EVIPNET's goal is to establish a sustainable regional network between key stakeholders in China (Beijing, Shandong and Sichuan), Lao PDR, Malaysia, Philippines and Vietnam to share knowledge on and promote evidence-informed health policy-making to improve health systems and population health.Objective1. To understand the current status of evidence-informed public health decision-making in Jinan City (including the information of evidence priovide, evidence use and evidence evaluation and the construction of related departments);2. To discuss the influence factors for the links between health researchers and policy makers; 3. To understand the health status of community residents and their needs and wishes of health services;4. To help decision-makers determine the priority health issues in EVIPNet-China and provide the public health evidence for the resolving of it.Methods1. The research of current status and influence factors of evidence-informed health decision makingIn this study, the health-related departments in Jinan were selected as research fields; quantitative research combined with qualitative research was the main method. The qualitative data were from the network database, compilation of the documents, conventional statistical information and depth interviews and focus group discussions; quantitative data were from the "questionnaire investigation, including two major contents "linkages between health researchers and policy makers and influence factors" and "expectations of policy makers and researchers on the future health decision-making system." the officials title with director division-level and above from health decision-making department and the researchers from health research institutions in Jinan was selected as research subjects, the former was named as the decision-making group hereinafter, and the latter was named as the research group. Set up a database by SPSS 11.5 and then analyze the data by SPSS, integrated use of a Literature Review, Ordinal logistic regression analysis, in-depth interview, focus group discussion,Chi-square test, and so on.2. The research of health status of community residents and their needs and wishes of health services in LiXia areaIn this study, the three resident committees more representative in the economic, demographic characteristics (Baotu Spring Area, Zhengjue Temple Area and Qinghou Area) were selected as research fields. On the premise of informed consent, the residents aged from 19 to 68 years old were investigated through outdoor interview by quantitative research methods. The content included two aspects as "health status of residents" and "the needs and wishes of health services". SPSS 11.5 was used to analyze the data.Results1. The research of current status and influence factors of evidence-informed health decision making The results showed 78.6% of the interviewees considered that the current health research evidence was not closely associated with the health decision-making, there existed gaps between them. The results of ordinal logistic regression analysis also indicated that awareness of evidence-informed decision-making, forms and ways of evidence, form of resource allocation and the mode of evidence assessment were main influence factors of evidence-informed health decision making. The Network Database was the best way of evidence access, and systematic review was the best form of evidence transmission.2. The research of health status of community residents and their needs and wishes of health services in LiXia areaThe education of residents was mainly junior and senior high school, the age structure was relatively young with average of 26.7 years. Two-week prevalence rate was 29.8%, chronic disease took the first place as rate of 29.7%, so it showed that chronic diseases were the main risk factors affecting the health of residents. The study also found that there were significant differences between the prevalence of chronic diseases and age, older people with hypertension, high cholesterol, coronary heart disease and diabetes were so much than young people. And the analysis of the needs and utilization of health services showed that the overall utilization rate for the community health services was 25.53%. Residents used medical services much than others. The analysis of response and satisfaction showed that dignity, comfort and service attitude were approbated, but independence, selectivity and medical cost were needed improving.Conclusion1. The research of current status and influence factors of evidence-informed health decision makingEvidence-informed public health decision-making, as a brand new concept, has not been thorough understood. The awearness of evidence-informed decision-making of decision-makers is still weak, and the linkage between policy makers and researchers was not closely enough. It is essential to establish a comprehensive network of health policy to provide a good platform for the exchange between researchers and policy makers, the research results can be used to make decision. Rational resource allocation, opitimizing way and form of evidence transmission, establishment of virtual Library and sharing point and the propaganda of evidence assessment system were guarantee to evidence-informed health decision making carrying on successfully.2. The research of health status of community residents and their needs and wishes of health services in LiXia areaThe result showed that the health state of the residents remained poor, the knowledge of residents on community health service residents was still limited. Mostly elderly people with chronic diseases, and also told us that with the aging of the population increase in this century, the elderly people will be the focus of community health services. Therefore, the government should play a leading role in understanding the current status of needs and utilization of the health service, understanding the actual needs of residents, paying attention to focus groups.Bring community health service into the priority issues of evidence-informed health decision making network, access to the information of residents and provide evidence for community health service network.