Presentation For 18th International Hph Conference(Fina 3l)

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1. Cross-Culture Research for Developing(Chinese version) WHO Self-Assessment Toolfor Health Promotion in HospitalZhou Fengqiong Depar tment of Health ManagementUniver sity of Montr eal, Montreal, QuebecT he 18 th Inter national Confer ence on Health Pr omotingHospital and Health Ser vice, Manchester, UK, 14-16A pril, 2010 2. ObjectivesThrough cross-culture research to develop aChinese version WHO self-assessment tool forHealth Promotion in Hospital(WHOSATHPH); Explore a high effective health care service modelthroughdevelopinghealthpromotion inhospital(HPH); Discuss the strategies for HPH development inundeveloped region. 3. ContextWhy the very different medical service conditions andresources perform the similar HP effect between China andthe Unite States? Total expenditure on health percapita (Intl $, WHO,2006) 4. Different HPH developing conditions: China vs the U.S China health service resource is serious scarce, the condition of China HPH developing is very tough China The USUndeveloped country, Gross Developed Country national income per Gross national income per capita (PPP internationalcapita (PPP international $): $): 4,66044,0701.3billion population0.3billion populationPolluted environment Healthy environment 5. per 10000 population( data resource : WHO) In Unite States, the cost of medical service is 5.9% of total family expenditureIn China, the cost of medical service is12.5% of total family expenditureOne China Shanghai best HPH teachingHospital ICU wardThe US. hospital advanced ICU ward 6. Different HPH developing conditions: China vs the US. China doctors office U.S doctors office Patients waiting roomChina hospital register centerThe US hospital register centerChina hospital crowded andnoisy waiting hall 7. The National Public Health Promotion EffectProbability of dying between 15 and60 years (per 1 000 population) (resource: WHO statistic data,2006) 8. MethodsCross-culture approach Translated the source instrument from English into Chinese; Backtranslated it into English. 2 health specialists and the authorof WHO self-assessment tool for HPH (Prof. Oliver Grone) commented the language equivalence of the backtranslation version.Pilot test: Investigated 8 Chinese health specialists in Montral.Spot field investigation (Non-probability sampling ) 22 Hospitals were sampled from three different Grades ChineseHospitals from 5 June to 30 August 2008; 40 hospital leaders, 3health management researchers, and 1 government officer wereinterviewed or investigated;The Sampling cities were chosen from the different economicdeveloped level in China: developed East region (Shanghai), middledeveloped region (Hefei), and undeveloped West-South region(Kunming); 9. 9 hospitals, 15 hospital leaders were from Shanghai;8 hospitals, 10 hospital leaders were from Hefei; 4 hospitals, 15 hospital leaders were from Kunming.All the respondents voluntarily completed the questionnaire survey independently; Repeated questionnaire survey was finished after 3-7 days based on voluntarily willingly.Sick-The name of Shanghai Sample Hospitals Gradebeds 10. Kunming Sample Hospitals Grade Sick-bedsThe First Affiliated Hospital of Kunming Medical University 15003The Second Affiliated Hospital of Kunming Medical University1200Wu Hua People Hospital2160Wu Hua Fengning Community Hospital 221Wu Hua Community Health Service Center0Anhui Sample HospitalsGrade Sick-bedsThe First Affiliated Hospital of Anhui Medical University 1890Hefei Second Civic People Hospital 5503Hefei First Civic People Hospital 1600Anhui Provincial Hospital 1400Hefei Second Civic People Hospital2321Shushan Administration Division San Li An Community Health Service Center481Shushan District community Health Service Center 50Shushan Jingang Town Community Health Service Center 50 11. ResultThe Reliability of Chinese version WHOSATHPH Only one word was marked as different meaning between the back translation version and the original version by all of 40 items ( the word in Chinese version --- back-translation -- the original version is : Satisfy -- Match). The general Cronbachs alpha of the Chinese version WHOSATHPH was 0.938. For each domains: management and policy was 0.793; patients assessment was 0.819; patient information and prevention was 0.807; healthy workplace was 0.785; continuity and cooperation was 0.755. The results showed that the Chinese version WHOSATHPH has high internal consistency and good language equivalence. But it still needs to enlarge the sample size for the further strict reliability and validity test. 12. The development level of China HPH (WHOSATHPH Investigation)Multi Variance Analysis, SPSS16The full score = 200, N of items=40; N of Hospitals=22, N of Hospital leaders=40The HPH general score: mean + SD = 154.1+ 36.87 (N= 22, 40)For five HPH standard domains(mean SD) from high to low:Continuity and cooperation 28.95 + 8.4 (72.4% of full score 40, N of items=8);Healthy workplace: 35.38 + 9.7(71.4% of full score 50,N of items=10);Patient information and prevention: 21.34 + 6.9 (71.1% of full score 30, N of items=6);Patients assessment: 23.85 + 7.1 (68.1% of full score 35, N of items =7);Management and policy 28.78+ 7.7 ( 62.6% of full score 45, N of items=9).Different Cities Hospitals HPH General ScoreShanghai HPH (N=15): 142.1 + 26.4The results indicated that ChineseHefei HPH (N=10): 162.3 + 40.0 hospital leaders self-assessed aKunming HPH (N=15): 160.6 + 42.6high HPH developing level. ChinaDifferent Grades Hospitals HPH General ScoreHospitals HP level didnt presentGrade III (N=21) Mean + SD: 154.19 + 7.3general statistic significantGrade II (N=9)Mean + SD: 158.67 + 10.7 difference in hospital size and inGrade I (N=11) Mean + SD: 144.82 + 14.54different economy developingregions.The general conclusion needs the further large size sampling investigation. 13. DiscussionChina HPH Developing Principles and strategiesEmphasize the patients-center, public benefits,disease prevention (ex. regularly free or cheappublic disease screening) and health professionalethics.Primar y healthcare service first. Focus on schoolhealth education and healthy lifestyle education.Depend on the regular evaluation and inspectionof medial ser vice quality and security; Emphasizethe important role of Traditional ChineseMedicine in HP.Stress on the adaptive healthcare ser vicedevelopment that match ing the national/regionaleconomic developing conditions.Focus on the HPH efficiency and closecooperation, stress on interactivity between thepatients, public, and health professional workers.focus on the exchange ofglobal successive experiences of advanced medical 14. China National Health Education Activities and Far-ranging National HP Movement Stress on the professional ethics and dedication spirit.Emphasize the public, universal, benevolent value of healthservice and National HP movement. 15. Lessons learnt from the US failing HPH practicesFocus on disease treatment but not disease prevention andhealth promotion. Health care system relies heavily onprivate and not-for-profit health insurance which is easy todrive the health care system toward the marketingbusiness direction. Over stress the moneyvalue of health service but ignore thepublic benefit value of health service.Over depend on the advanced medicalprofessional service but ignore thenational HP, ignore the entiresociety(public) participation ofhealth promoting movement. 16. Conclusions issuesAn undeveloped country can expressing HPH through national develop an effectivehealth education and HP movement. HPH might be not related to thehospital sized and the advanced expensive service conditional. Foster anational HP value and culture is more effective and important than uniquemoney investment for HPH developing. International culture-crossresearch of HPH is important for HPH developing.ealth s ified hl dever aign and N ationa amp rt p rom otion c nance suppo ent figo vernm tment,n and Treavice.e ventio Medical Sersize PrdSynthe and Advance yPrimar ls, odeem se rvic hange edical al excified m demicers bal ace div lozegfestyle iUtil urageon healthy lico 17. AcknowledgeUniversity of Montreal Department of Administration of Health (FarandLambert, Rgie Blais, et al) Direction of International Relation( Yves Guay)Fudan University (Fu Hua, Zhou Lei, et al) Anhui Medical University ( Ma Ying, et al) Kunming Medical University( Wan Chonghua, et al) Montreal University Women Club. Professor: Oliver Grone and Jiqian Fang 18. China research cooperation partners for this researchProfessor Fu Hua(First Line, middle)and his graduatedstudents (Shanghai)Dr. Ma Ying`sstudentsProf. Wan Chonghua(Hefei)(Kunming)