What do we know about the strengths and weakness of different policy mechanisms to influence health behaviour in the population?

With health care systems under increasing pressure the development of a well defined and effective public health strategy has never been more important. Many health problems are potentially avoidable and governments have long had tools at their disposal to influence population health and change individual behaviours, directed both ‘upstream’ at some of the underlying causes of poor health, as well as at ‘downstream’ challenges when poor health behaviours are already manifest. But how effective are these different actions? This policy summary briefly maps out what is known about some of these mechanisms, including approaches that have come to recent prominence from behavioural economics and psychology. Combinations of taxation, legislation and health information remain the core components of any strategy to influence behavioural change. There remain many unanswered questions on how best to design new innovative interventions that can complement, and in some instances augment, these well established mechanisms.

Promoting health, preventing disease: is there an economic case?

A core question for policy-makers will be the extent to which investments in preventive actions that address some of the social determinants of health represent an efficient option to help promote and protect population health. Can they reduce the level of ill health in the population? How strong is the evidence base on their effectiveness and, from an economic perspective,how do they stack up against investment in the treatment of health problems? Are there potential gains to be made by reducing or delaying the need for the consumption of future health care resources? Will they limit some of the wider costs of poor health to society, such as absenteeism from work, poorer levels of educational attainment, higher rates of violence and crime, and early retirement from the labour force due to sickness and disability? This policy summary provides an overview of what is known about the economic case for investing in a number of different areas of health promotion and noncommunicable disease prevention. It focuses predominantly on addressing some of the risk factors for health: tobacco and alcohol consumption, impacts of dietary behaviour and patterns of physical activity, exposure to environmental harm, risks to mental health and well-being, as well as risks of injury on our roads.

Public health in Austria: an analysis of the status of public health

This book explores the key challenges facing Austria’s public health system. Set firmly in the context of the history, scope, functions and responsibilities of public health in developed countries, it examines how the Austrian system has developed and adapted over the last 50 years to the benefit of the population. It also looks at the challenges presented by life in the 21st century. The book draws on both national research and expert interviews to present a fully rounded picture. This shows that the public health system in Austria is struggling to maintain essential services and develop policies for improvement, and the study proposes strategies and policies to tackle these developments, looking in particular at change within the fields of education, research and training. This book is essential reading for policy-makers, advisers and analysts interested in developing a public health strategy and competence in both developed and developing countries, as well as researchers interested in the Austrian health system.

Sind lebenslanges Lernen und Revalidierung Garanten für die Praxistauglichkeit von Ärzten?

Man ist sich zunehmend einig darüber, dass eine abgeschlossene medizinische Grundausbildung für einen Arzt nur den ersten Schritt im lebenslangen Lernen bildet. In vielen Ländern geht man dazu über, die fortlaufende Aktualisierung von Kenntnissen und Fertigkeiten motivierend zu unterstützen und in einigen Fällen auch zu fordern. Das vorliegende Grundsatzpapier befasst sich mit Ansätzen für eine Revalidierung von Ärzten, die in Europa im Entstehen sind. Nach einer Diskussion der den Rahmen setzenden und die Auswahl der Ansätze beeinflussenden Faktoren folgt ein Überblick über den Stand von Erarbeitung und Umsetzung der Konzepte in europäischen Ländern, wobei auf die problematischen Punkte besonders eingegangen wird. Flankierend werden Beispiele aus Australien, Neuseeland und den Vereinigten Staaten von Amerika angeführt und abschließend die Erkenntnisse aufgrund der verschiedenen Herangehensweisen diskutiert und Optionen für die Umsetzung erörtert.

Обеспечивает ли система непрерывного обучения и переаттестации поддержание необходимого профессионального уровня врачей?

Становится все более общепринятым мнение о том, что завершение курса преддипломного медицинского обучения – это лишь первый шаг в процессе непрерывного обучения врачей, которое продолжается на протяжении всейпрофессиональной жизни. Многие страны предпринимают меры по поддержке и стимулированию процессов постоянного обновления навыков и знаний медиков, а в некоторых случаях – предусматривают это в качестве обязательного требования. В настоящем кратком аналитическом обзоре рассмотрено развитие подходов к ревалидации врачей в Европе. После обсуждения контекстуальных факторов, влияющих на выбор тех или иных подходов, дан краткий очерк процессов их развития и внедрения в различных странах Европы и выделены основные проблемы в этой области. Представлены также примеры из других стран, таких как Австралия, Новая Зеландия и США. Затем приведен анализ фактических данных, относящихся к различным подходам. В заключение обсуждаются некоторые варианты практического внедрения.

Est-ce qu'un apprentissage permanent et la revalidation des compétences garantissent la capacité d'exercer des médecins ?

Il est de plus en plus admis que l’obtention d’un diplôme universitaire en médecine n’est que la première étape d’un long processus de formationpermanente. Bon nombre de pays appliquent actuellement des mesures en vue de soutenir, d’encourager et, dans certains cas, d’exiger une mise à jour continue du savoir et des compétences. La présente synthèse examine les nouvelles stratégies adoptées pour « revalider »les médecins d’Europe. Après avoir analysé les facteurs contextuels influençant le choix des stratégies et démarches utilisées, ce document étudie la manière dont les pays européens ont élaboré et mis en oeuvre les politiques en la matière, en mettant en lumière les principaux défis ainsi posés. Des exemples d’autres pays tels que l’Australie, les États-Unis et la Nouvelle-Zélande sont aussi mentionnés. Les informations factuelles sur les différentes stratégies adoptées sont ensuite examinées. Enfin, plusieurs méthodes de mise en oeuvre sont abordées.

Do lifelong learning and revalidation ensure that physicians are fit to practise?

It is increasingly accepted that completing undergraduate medical education is only the first step in a process of lifelong learning for physicians. Many countries are putting in place measures to support and encourage and, in somecases, to require continual updating of skills and knowledge. This policy brief examines emerging approaches to revalidating physicians in Europe. Following a discussion of the contextual factors influencing the choice of approach, the brief reviews how European countries have developed and implemented policies, highlighting the significant challenges. Examples from other countries such as Australia, New Zealand and the United States of America are also presented. Evidence relating to the different approaches isthen reviewed. Finally, some implementation options are discussed.