Lead: Health manager refers to the national occupation unique to the health industry, and the vocational skill appraisal guidance center of the Ministry of Health is responsible for the nationwide vocational qualification appraisal. Those who pass the examination will be awarded the national vocational qualification certificate of People's Republic of China (PRC).
First, the definition of health managers
Health managers are people who manage the health of individuals and people in a popular way. But what is a health manager, what is his job, and what is the difference from other jobs?
1. Health
To understand a health manager, we first need to understand what health is. Many people think that "health means not getting sick and not being weak". In fact, in 1948, the World Health Organization (WHO) put forward the definition of health. "Health is not just the absence of disease or weakness, but a good state of physical, mental and social adaptation"; In 1990, the World Health Organization (WHO) further elaborated on health, saying that it is sound in four aspects: physical health, mental health, good social adaptation and moral health. 1999, the World Health Organization (WHO) formulated a new health standard, namely "five precepts and three virtues": eating fast, defecating fast, sleeping fast, talking fast, walking fast, good personality, good social skills and good interpersonal relationships. It can be seen from WHO's definition of health that people's understanding of health is more and more comprehensive and profound, and people are paying more and more attention to health.
2. Health Manager
Health management is the whole process of comprehensive monitoring, analysis, evaluation, prevention and maintenance of health risk factors of healthy people, sub-healthy people and sick people. Based on health information management, health managers use knowledge of medical basics, clinical medicine, nutrition and health care, traditional Chinese medicine health care, psychological health care, rehabilitation medicine, environmental medicine, sports medicine, safe medication, etc., and carry out health education, health promotion, health consultation and guidance according to the different characteristics of different groups of people, so that people or individuals can reach the best health state, and finally achieve the purpose of prolonging life and improving quality of life. Therefore, health managers must have all kinds of knowledge and skills. Several professional skills that health managers must first possess:
Basic medicine: master basic medicine, understand the basic structure of human body, and know some common diseases.
Prevention and health care of common diseases and chronic diseases: 1993, the World Health Organization (WHO) declared that unhealthy lifestyle was the number one killer. According to the statistics of China Health Department, 75% of the deaths in China in 1990s were due to lifestyle diseases. Do a good job in the prevention and health care of common diseases and chronic diseases, effectively control the occurrence of chronic non-communicable diseases, improve people's quality of life and reduce medical expenses.
Nutrition: Nutrition is the basic source of health. Master nutrition, make scientific nutrition meals for different customers, provide reasonable nutrition guidance, cultivate their good lifestyle and behavior, promote their health and improve their quality of life.
Rehabilitation medicine: provide professional rehabilitation guidance to patients with chronic diseases or physical disabilities, and use physical therapy and exercise therapy to help them recover or improve their dysfunction, improve and restore their physical function and work ability. At present, most of the causes of human death are myocardial infarction, cerebrovascular accident, cancer and trauma. The mortality rate of patients with myocardial infarction after rehabilitation treatment is 36.8% lower than that of those without rehabilitation treatment. Among the survivors of cerebrovascular accident, active rehabilitation treatment can cure 90% patients, and 30% patients can resume some lighter jobs. 40% cancer patients can be cured, and 60% incurable patients can live 15 years.
Kinematics: Reasonable exercise can improve the body's immunity and adaptability, enhance cardiopulmonary function, recover and improve the damage caused by diseases, and better restore the body's function, labor ability or self-care ability.
Psychology: master psychology, provide psychological help to clients in time, inspire and mobilize clients to improve their behavioral motivation and potential, eliminate their psychological problems and obstacles, promote their personality endurance and development, enhance their self-confidence, help them adjust their goals in time, strengthen self-control, actively develop themselves and work and live better.
Environmental science: master environmental science, know the relationship between environment and health, and realize the relationship between the change of ecological environment and the epidemic of infectious diseases. The change of ecological environment will cause the epidemic of some infectious diseases; Understand that environmental pollution has brought irreparable harm to human beings, such as dengue fever and plague epidemic in tropical areas caused by climate warming, and red tide caused by pollution in offshore waters caused by improper farming and production methods. Create an environmentally friendly consumption pattern, do a good job in environmental sanitation and protect human health.
Management science: The application of management science can provide health consultation, collect health information, conduct accurate health assessment, formulate effective health education plans, implement health education as planned, and implement health intervention measures to solve their health problems.
Second, health management work
Health management includes:
Health information collection: that is, collecting information such as health physiological indicators, lifestyle and psychological state of individuals or groups to find health problems and provide basic data for evaluation and intervention management;
Assessment of health risk factors: predict the health status and development trend of individuals or groups in order to achieve the role of health early warning and provide basis for intervention management and evaluation of intervention effects;
Health promotion intervention management: that is, through the action plan of individual or group health improvement, personalized health guidance is implemented for different risk factors.
Through the above three processes, the purpose of improving health, preventing the occurrence and development of chronic non-communicable diseases, improving the quality of life and reducing medical expenses can be achieved.
2. Health management trilogy
Health management studies how people should manage their lives to promote health. As a service, health management will guide people to health through the following three steps.
Step 1: Know your health status-health assessment.
Only by knowing the individual's health condition can we effectively maintain the individual's health. The specialized health information system will provide a series of health and disease risk assessment reports based on the analysis of relevant health information, and help individuals and collectives identify relevant risk factors and healthy development trends. The results of health assessment and corresponding health information can be dynamically managed between health managers and individuals through the Internet.
Step 2: Manage your health-health plan.
Personalized health management plan is the key to identify and effectively control personal health risk factors. We will pay attention to those indicators that can be changed or controlled, put forward the goals of health improvement, and provide action guides and related health improvement modules. It not only provides the principle of preventive intervention, but also provides an effective tool for communication between doctors and individuals.
Step 3: Improve your health-take action.
Help individuals take action to achieve the goals of personal health management plan in various forms. Under the guidance of health administrators, individuals choose the means of self-maintenance, and achieve the effect of health improvement through personal health management diary, special health maintenance courses and follow-up measures.
Third, the health management industry analysis
The rapid development of modern society puts forward higher requirements for people's physical and mental health. The development of social economy has brought people a happy life. However, due to the accelerated pace of life, rapid changes in values, knowledge explosion, fierce competition, increasingly complex interpersonal relationships, serious damage to the natural environment, and increasingly serious social harm, various diseases, especially non-communicable chronic diseases, have increased significantly, such as heart disease, cerebrovascular disease, cancer, mental illness, etc., and the morbidity and mortality have gradually increased. The mortality rate of cardiovascular and cerebrovascular diseases and cancer patients ranked seventh, eighth and ninth in the 1950s, and first, second and third in the 1980s, which was almost the same as that of developed countries. According to data reports, the mortality rate of patients with heart disease and cerebrovascular disease in the United States accounts for 50% of the total mortality rate; The mortality of cancer patients accounts for 20% of the total mortality, that is, the mortality of cardiovascular and cerebrovascular diseases and cancer patients accounts for 70% of the total mortality. The mortality rate of these three types of patients in China accounts for 7 1% of the total mortality rate. These diseases seriously affect our health and life. 199 1 The 13th World Conference on Health Education clearly pointed out: 60% of diseases in modern society are caused by unhealthy lifestyles (75% in developed countries and 45% in developing countries), and 70%-80% of people die from this lifestyle disease. From a global perspective, the most unhealthy lifestyle and the most dangerous behavioral factors are: smoking, excessive drinking, unreasonable diet structure, lack of exercise, decreased psychological stress and car accidents. Therefore, many countries call diseases caused by unhealthy lifestyles "lifestyle diseases", that is, cardiovascular and cerebrovascular diseases, cancer, obesity, diabetes and so on. Lifestyle diseases seriously threaten human health and longevity, and make many countries pay a heavy price. Experts warned: "If people don't change their unhealthy lifestyles, lifestyle diseases will be prevalent throughout the country and even around the world." Lifestyle disease is also called "civilization disease" and "wealth disease", and there is a new term called "self-creation disease", which is comfortable, unconscious, subtle and formed for a long time. The former Director-General of the World Health Organization said that "luxury cars, attractive cigarettes, rich diet and lazy life are hidden dangers", which bring diseases and premature death. Most people die because of their lifestyle and behavior. This is not a natural disaster, but a man-made disaster. Dr. Nakajima Hiroshi, former director-general of the World Health Organization, said: "Most problems affecting health and premature death in the world can be prevented by changing people's behavior." If people can gain scientific knowledge about smoking, diet and physical exercise, the total number of adult deaths can be reduced by more than 50%. According to the statistics of the World Health Organization, if people want to realize the four efficient and low-cost lifestyles of "no smoking, no drinking, balanced diet and proper exercise", they can at least increase the life expectancy of 10 years. Health management is to promote people to adopt a healthy lifestyle, prevent diseases and improve the quality of life through health education, health promotion and behavioral intervention.
Therefore, the development of health management industry is a top priority in China.
Compared with advanced countries in Europe and America, such as the United States, Britain, Germany, Finland and other countries, the development of China's health industry is relatively backward. Especially the professional title of health manager was put forward after China entered the 2 1 century. Compared with the lack of some services in China's medical and health service system, it has seriously affected the health level of our people. For example, "hypertension health", "diabetes health" and "cancer is better for health". If we only rely on hospital medication and traditional health service methods, the effect is far from the "prognosis expectation" of patients. For non-communicable diseases such as hypertension and diabetes, besides medication, it is particularly important to implement health guidance and management. From June 5438 to 10, 2005, China's Ministry of Labor and Social Security officially launched the new profession of "Health Manager". The introduction of "health manager" in our country shows that our government has realized the importance and necessity of "health manager" to the health of our people.
As a new profession in society, health managers naturally use it without mature and ready-made industry working standards. Although some foreign countries can learn from it, the "stone from other mountains" may not be suitable for China's national conditions, at least not all. It will take a detour to copy and apply, and it is necessary to create the "China Health Manager Standard" in line with China's national conditions. This requires the health managers in China to explore diligently from practice. More importantly, the relevant national functional departments need to collect and summarize the feedback information from all over the country in time, and take * * * as the industry standard for health managers to summarize and screen the content. For example: collecting and managing health information of individuals or groups; Assess the relative risk of health and disease of individuals or groups; Carry out individual or group health consultation and guidance; Making health promotion plans for individuals or groups; Health maintenance, intervention and promotion, guidance and management of individuals or groups. And explore, summarize and supplement the relevant contents in practice, so as to gradually improve or tend to improve the industry working standards of health managers, make the daily work of health managers have rules to follow and evidence to test, and promote their operational norms to enter a virtuous circle. With the same rules and regulations and enhanced operability, people will trust health managers. Because the national labor and social security department of our country officially launched the new profession of "health manager", it shows that the health problems of the population after the failure of medical and health reform in China have attracted the attention and attention of the national high-level officials.
Many survey data and real life show that China is still a developing country, and its GDP (gross national product) is still on the verge of per capita poverty. The incidence of chronic non-communicable diseases is not only high, but also increases rapidly in many projects. For example, the fourth national nutrition survey in 2002 showed that the incidence of hypertension among Chinese residents increased significantly. /kloc-The prevalence rate of hypertension among residents over 0/8 years old is 18.8%, and the number of patients in China is about1600,000. Compared with 199 1 year, the prevalence rate increased by 3 1%. Another survey confirmed that 17.8% residents in the west of China suffered from chronic diseases. For example, the prevalence of diabetes increased significantly, from 1979 to 0.67% of the total population to 3.6% in 2003. In less than 20 years, China has rapidly entered the ranks of countries with moderate prevalence of diabetes (3% ~ 10%), becoming the second largest diabetes country in the world after India. In particular, the onset age of diabetes in China is younger, and the age group of 30-44 is 4.44 times that of all age groups. The special age group of "30-44 years old" is the "backbone" of the country, unit and family. Chronic non-communicable diseases such as diabetes and hypertension cannot be solved only by the service system of medical and health institutions. This situation requires health managers to stick to it rationally, serve the people's health management well, and sincerely help the people to alleviate the mental and physical health problems caused by sub-health symptoms such as chronic diseases.
Fourth, the health management industry outlook
In the past 50 years, China's medical and health system has always been to provide free medical care for urban workers, while rural people in urban and rural areas have not enjoyed basic medical and health benefits. In the past reform process, China's medical and health field is a rare virgin land in China's social field. Therefore, the health care services enjoyed by the people are also at a low level. From 65438 to 0999, the country started the process of medical system reform. This reform is bound to have a historic and far-reaching impact on the economic life, the consumption patterns and concepts of medical care, the quality of life and the improvement of health quality of all Chinese people. According to the statistics of national authoritative organizations, the resident population in China has reached 389 million, and the annual per capita medical and health care expenditure is 3 18. 1 yuan, including medical expenses of 243.3 yuan and medical and health care expenses of 4 1.7 yuan. The total amount of funds invested by urban residents in the health care market in China has reached 1237.6438+05. The total amount of money invested in the medical and health market nationwide reached 224.6 billion yuan. With the rapid development of China's social economy and the improvement of the overall quality of life, especially in the vast coastal areas, people pay more and more attention to improving the health quality of themselves and their families. The concept of health preservation and health promotion is more and more deeply rooted in people's hearts. Facing the 2 1 century, the brand-new health concept orientation and the reform of medical and health insurance system are bound to have a series of significant impacts on the consumption of medical and health care market. At the same time, due to the income differences of all social strata, healthy consumption also presents a high, medium and low-grade structure. For many years, China's medical and health service field has been in a state of state monopoly, with few market competitors, and the whole field is in a state of short supply and poor service quality. With the all-round development and sustained growth of China's social economy, especially after China's entry into WTO, China's medical community can not meet the needs of modern health services in terms of management system, operation mechanism, software and hardware facilities and service quality.
Modern people should not only deal with the fast-paced study, work and life, but also deal with all kinds of complicated social interpersonal relationships. Faced with more and more competition and challenges, people's physiology and psychology are constantly weakening, aging and pathological changes. Although this process is slow and not obvious, it is difficult for wealthy families to recover once they get sick. At present, the incidence of various "civilized diseases" and "rich diseases" such as coronary heart disease, hypertension, hyperlipidemia, hyperglycemia and diabetes is increasing year by year, and it is getting younger and younger. The occurrence of these diseases made people realize the importance of health and gradually began to pay attention to health management. WHO clearly declared: "The inheritance of health and longevity accounts for 15%, social factors account for 10%, medical conditions account for 8%, climatic conditions account for 7%, and 60% of the ingredients depend on themselves." In other words, everyone's life is in their own hands. The new concept of health management is to change passive management of human health into active management, and help people recover, maintain and promote health scientifically. Facing the 2 1 century, who put forward a resounding slogan for the health problems of all mankind: "a new vision of health, from ideal to practice." It requires that health work should be changed from traditional disease treatment to people-oriented, health-oriented and human development-oriented, and its core concept is to maintain and promote health.
The emerging fourth medicine (health care medicine) in the world is different from the first medicine (clinical medicine), the second medicine (preventive medicine) and the third medicine (rehabilitation medicine). It is no longer just for diseases and patients to eliminate diseases and save lives, but to emphasize health maintenance and health management, in order to improve the quality of life and achieve fitness, and to establish a set of humanized health plans. The content of health management not only covers all the contents of the first medicine, the second medicine, the third medicine and the fourth medicine, but also focuses on the fourth medicine. Health management is to provide systematic and continuous personalized health care services for every member of society, that is, consumers of health care services, by organically integrating the resources of health service providers such as medical institutions, health care institutions and insurance organizations, so that consumers can obtain the most comprehensive and effective services at the most reasonable cost. Dr. dee. W.Edington, director of the Health Management Research Center of the University of Michigan, once suggested that after more than 20 years of research on health management in the United States, he came to a conclusion that health management has such a secret for any enterprise and individual, that is, 90% and 10%. Specifically, after 90% of individuals and enterprises passed the health management, the medical expenses dropped to the original 10%. 10% of individuals and enterprises did not do health management, and medical expenses increased by 90%. Health management is an idea, a method and a set of perfect and thorough service procedures. Its purpose is to make patients and healthy people have better health, restore health, promote health, save money as much as possible and effectively reduce medical expenses. In the United States, more than 70% of employers buy health management plans for their employees. What prompted people to shift from the traditional medical payment model to health management? In fact, the reason is simple: the national medical expenditure is increasing. At present, the annual medical expenditure in China exceeds $654.38 billion, and the implementation of health management can at least reduce the annual expenditure by 654.38+00%. In China, the huge expenditure of the state, enterprises and individuals on social medical insurance is also amazing. Taking the medical care expenditure of urban population in China in 2000 as an example, the per capita consumption expenditure of medical care for 389 million people was 3 18. 10 yuan, including medical expenses of 243.30 yuan and medical care of 4 1.70 yuan. The total amount of funds invested in the health care market is 65,438+037.38+. If the annual growth rate is 13% (health expenditure is higher than income growth rate), the total market value of China medical industry will be 640 billion yuan by 2005. According to this calculation, the average growth in five years will not be less than150 billion yuan. The extensive implementation of health management plan will greatly reduce the medical expenses of the state, enterprises and individuals. The medical and health industry in China is undergoing market-oriented and socialized reform, and the government is transforming the medical and health industry from a planned economy to a market economy. China health management industry has entered the initial stage.
Experts predict that in the next five to 10 years, the global medical industry will undergo subversive changes, from disease treatment to preventive health care; From the perspective of preventive medicine, 70% of diseases can be avoided or reduced through prevention. All these provide good opportunities for the development of health management. In today's China, the spread of infectious diseases, the expansion of chronic diseases and the increase of occupational diseases have gradually enhanced people's health awareness. In addition, with the rapid development of urban economy and the continuous improvement of living standards, health management is expected to become another emerging high-speed growth industry after IT.
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