Community health service institutions are the bottom of the infectious disease prevention and control system, and it's crucial to the control of urban epidemic situations. After the COVID-19, the prevention and control capacity of community health service institutions in Beijing has been improved, but there is a lack of evaluation, and the direction of future improvement is not clear.
To evaluate the changes in the infectious disease prevention and control capacity of community health service institutions in Beijing during the COVID-19 period, analyze the influencing factors, and put forward suggestions for improvement measures, so as to provide a scientific basis for further enhancing the prevention and control capacity of infectious diseases at the grass-roots level.
From 2019 to 2022, questionnaires were conducted on 334, 354, 405 and 405 community health service centers and independent community health service stations willing to cooperate with the survey in Beijing. The quantitative scoring method was used to measure the comprehensive capacity of infectious disease prevention and control of various institutions from the sentinel setting (20 points), pathogen detection of common infectious diseases (30 points), and the emergency capacity of responding to infectious diseases and public health emergencies (50 points). Linear mixed model is used to compare the changes in the prevention and control capacity of various institutions from 2019 to 2022, and the factors affecting the improvement of the prevention and control capacity of infectious diseases are analyzed.
The median scores of comprehensive capacity for infectious disease prevention and control in 2019-2022 were 50 (43, 60), 63 (43, 70), 70 (50, 80) and 70 (50, 80), respectively. The differences between each year were statistically significant (P<0.05) .Linear mixed model showed that, organization category, whether to set up preventive health care department, whether to have P2 laboratory, the actual number of employees have an impact on the comprehensive ability of infectious disease prevention and control (P<0.05). The comprehensive capacity of infectious disease prevention and control in community health service centers was 18.94 (95%CI=15.73-22.15, P<0.05) higher than that of independent community health service stations, and the comprehensive capacity of the prevention and health care department was 6.50 (95%CI=4.00-9.01, P<0.05) higher than those without, the institution of infectious disease prevention and control with P2 laboratories was 2.59 (95%CI=0.62-4.55, P<0.05) higher than those without, and the capacity for infectious disease prevention and control of institutions with a larger number of on-the-job staff was increased by 0.05 (95%CI=0.03-0.07, P<0.05) .
During the period of COVID-19 disease, the prevention and control capacity of the community health service institutions in Beijing has been improved year by year, mainly influenced by factors such as the type of institutions, the setting of prevention and health care departments, the setting of P2 laboratories and the actual number of people on duty. It is suggested to invest continuously, rationally allocate resources, strengthen personnel training, and establish a sound working mechanism.
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.
To sort out and summarise the implementation progress and trend of essential public health services in Shenzhen 2017-2022, and provide reference for further promoting the high-quality development of essential public health services in Shenzhen.
From July 2022 to April 2023, collect 56 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.
(1) The actual funding in place for the National Essential Public Health Service Program in Shenzhen had increased from 80.71 yuan in 2017 to 144.86 yuan in 2022, the total number of primary health workers had 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 were -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.
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.
