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Progress and Trends in the Implementation of Essential Public Health Services in Shenzhen,2017-2022

  

  1. 1.School of Health Policy and Management,Chinese Academy of Medical Sciences/Peking Union Medical College,Beijing 100005,China 2.Business Management Section,Shenzhen Center for Disease Control and Prevention,Shenzhen 518073,China 3.Center for Project Supervision and Management,National Health Commission,Beijing 100044,China
  • Received:2023-09-29 Revised:2023-11-18 Accepted:2023-11-28
  • Contact: YOU Lili,Associate Professor;E-mail:youlily_pumc@163.com LIU Gang,Chief Physician;E-mail:sliugang@163.com

2017—2022年深圳市基本公共卫生服务实施进展与趋势

  

  1. 1.100005 北京市,中国医学科学院 / 北京协和医学院 卫生健康管理政策学院 2.518073 广东省深圳市,深圳市疾病预防控制中心业务管理科 3.100044 北京市,国家卫生健康委员会项目资金监管服务中心
  • 通讯作者: 尤莉莉,副教授;E-mail:youlily_pumc@163.com 刘刚,主任医师;E-mail:sliugang@163.com
  • 基金资助:
    美国中华医学会基金项目(CMB 18-296);深圳市“医疗卫生三为工程”项目资助(项目编号:SZSM202011008)

Abstract: Background Since the National Essential Public Health Service Program was launched in 2009,various services have been commonly carried out across the country,and the implementation and progress of the program varies among provinces and cities due to their different levels of economic development. As a national economic center city and a national innovative city,Shenzhen is at the forefront of informatization technology in cities across the country. Objective To sort out and summarise the implementation progress and trend of essential public health services in Shenzhen from 2017—2022,and provide reference for further promoting the high-quality development of essential public health services in Shenzhen. Methods From July 2022 to April 2023,Collect 54 evaluation indicators of essential public health services in Shenzhen from 2017 to 2022,and analyse the trend of each indicator during the six-year period;Results (1)The actual funding in place for the National Essential Public Health Service Program in Shenzhen has increased from 80.71 yuan in 2017 to 144.86 yuan in 2022,the total number of primary health workers has increased from 9 992 to 13 758,and the proportion of public health physician in the primary medical staff increased from 5.39% to 5.94%.(2)The average annual growth rates of the electronic health record filing rate,the newborn visit rate,the health management rate for children aged 0-6 years,the early pregnancy filing rate,the postnatal visit rate,maternal system management rate,the health management rate for the elderly,the standardised management rate for patients with severe mental disorders,the standardised medication rate for TB patients,and the rate of TCM health management services for the elderly and children aged 0-36 months,were respectively 6.27%,0.32%,2.61%,1.06%,0.07%,0.62%,8.34%,2.11%,0.51%,9.53%,and 5.01%,while the rates of health record utilisation,standardised management of hypertensive patients,and standardised management of diabetic patients decreased from 77.40%,72.48%,and 72.09% in 2017 to 36.58%,64.14%,and 66.32% in 2022.(3)The average annual growth rates of health literacy rate,the proportion of people participating in physical exercise,and the rate of exclusive breastfeeding of infants within six months are 23.75%,15.86%,and 5.35%,and the average annual growth rates of the neonatal mortality rate,the infant mortality rate,and the mortality rate of children under five years of age are -1.71%,-4.25%,and -1.63%. Respectively,the blood pressure control rate of the managed population and the blood glucose control rate of the managed population decreased from 70.84% and 67.41% in 2017 to 69.33% and 60.82% in 2022,and the average annual growth rates of the cesarean section rate,the incidence of birth defects,the low birth weight rate,the low weight rate of children under the age of 5,the prevalence of anaemia in children under the age of 5,and the obesity rate of children under five-years old were 0.74%,1.87%,3.97%,3.85%,11.03%,and 33.50%.The rate of public knowledge decreased from 86.26% to 68.77%,and the rate of resident satisfaction increased from 88.51% to 91.00% from 2018 to 2022. Conclusion Shenzhen's essential public health services from 2017 to 2022 have achieved remarkable results:organization and management and financial expenditure have been strengthened,and the human resources continues to grow stronger;all types of populations have wide coverage,and the effect of health education has begun to show. However,the use of health records needs to be strengthened,and there is a need to further promote the "the elderly,the high pressure,and the diabetes" program management quality development,and constantly improve the knowledge rate and sense of access of the residents.

Key words: Public health surveillance, National essential public health service program, Performance assessment, Evaluation study, Shenzhen

摘要: 背景 自2009年启动国家基本公共卫生服务项目以来,全国各地普遍开展各项服务,由于各省市经济发展水平不同,其基本公共卫生服务项目的实施情况和进展也不同。深圳市作为全国性经济中心城市和国家创新性城市,信息化技术位于全国城市前列。目的 梳理并总结深圳市2017—2022年基本公共卫生服务的实施进展与趋势,为进一步推进深圳市基本公共卫生服务高质量发展提供参考。方法 于2022年7月—2023年4月,收集2017—2022年深圳市项目投入、项目执行和项目效果3个维度共计54项的基本公共卫生服务评价指标,分析各指标在2017—2022年六年间的变化趋势。结果 (1)深圳市基本公共卫生服务项目实际到位经费从2017年的80.71元增加到2022年的144.86元,社康工作人员总数由9992人增长到13758人,公卫医师占基层医务人员比例从5.39%提高到5.94%。(2)电子健康档案建档率、新生儿访视率、0~6岁儿童健康管理率、早孕建册率、产后访视率、孕产妇系统管理率、老年人健康管理率、严重精神障碍患者规范管理率、肺结核患者规范服药率、老年人中医药健康管理率、0~36个月儿童中医药健康管理服务率的平均年增长率分别为6.27%、0.32%、2.61%、1.06%、0.07%、0.62%、8.34%、2.11%、0.51%、9.53%、5.01%,而健康档案使用率、高血压患者规范管理率、糖尿病患者规范管理率从2017年的77.40%、72.48%、72.09%减少至2022年的36.58%、64.14%、66.32%。(3)居民健康素养具备率、参加体育锻炼人数比例、6个月内婴儿纯母乳喂养率的平均年增长率分别为23.75%、15.86%、5.35%,且新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率的平均年增长率分别为-1.71%、-4.25%、-1.63%;管理人群血压控制率、管理人群血糖控制率从2017年的70.84%、67.41%下降至2022年的69.33%、60.82%,剖宫产率、出生缺陷发生率、低出生体重率、5岁以下儿童低体重率、5岁以下儿童贫血患病率、5岁以下儿童肥胖率的平均年增长率分别为0.74%、1.87%、3.97%、3.85%、11.03%、33.50%。2018—2022年群众知晓率从86.26%下降至68.77%,居民满意度从88.51%增加至91.00%。结论 深圳市2017—2022年基本公共卫生服务取得显著成效,组织管理和财政支出不断加强,主体责任得到落实,人力资源队伍不断壮大;各类人群覆盖面广,健康教育效果初显,然而档案利用有待加强,需要进一步推进“老高糖”项目管理高质量发展,不断提高居民的知晓率和获得感。

关键词: 公共卫生监测, 国家基本公共卫生服务项目, 绩效评估, 评价研究, 深圳

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