| 上海实施国家基本公共卫生服务项目十年效果评价 |
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| 引用本文： | 黄萍,汪铭涵,张安,常佩瑶,李连香,高中制.上海实施国家基本公共卫生服务项目十年效果评价[J].中华全科医学,2020,18(12):1979-1983. |
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| 作者姓名： | 黄萍 汪铭涵 张安 常佩瑶 李连香 高中制 |
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| 作者单位： | 上海中医药大学公共健康学院, 上海 201203 |
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| 基金项目： | 上海市卫生健康委员会委托项目(HWJC201901) |
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| 摘 要： | 目的 上海自1997年开始探索建立基本公共卫生服务体系以来,逐步建立健全基本公共卫生服务的网络体系。通过梳理过去十年的基本公共卫生服务项目数据,了解上海实施基本公共卫生服务项目十年的实施效果,总结上海提供基本公共卫生服务的特点,为后期更有效的提供卫生服务提出政策意见。 方法 收集2009—2019年度上海实施基本公共卫生服务项目的数据,通过年度纵向分析,获得十余年间各项指标具体变化及整体趋势,通过Wilcoxon秩和检验比较本市全面推广家庭医生制度前后各项指标数值的差异。 结果 上海开展的国家基本公共卫生服务项目数历年始终为100%。十年间,居民健康档案的建档人数逐年上升至1 992.01万人。妇女、儿童、高血压和糖尿病患者等重点管理对象的服务数量均达到国家要求的水平,孕产妇死亡率下降至3.51/10万,婴儿死亡率下降至3.06‰。儿童健康管理率达到98.47%。高血压和2型糖尿病患者管理率分别达84.77%和87.37%。Wilcoxon秩和检验表明,家庭医生制度的落地之于孕产妇死亡率、婴儿死亡率的下降及早孕建册率、产后访视率、高血压管理人群血压控制率等指标的提高,差异均具有统计学意义(均P<0.05)。 结论 上海实施基本公共卫生服务项目取得了显著成效,但仍需在电子健康档案标准化建设、公共卫生经费监管考核机制、强化公共卫生服务人才的引进力度等方面继续改进。
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| 关 键 词： | 国家基本公共卫生服务 实施效果 效果评价 |
| 收稿时间： | 2020-08-06 |
Evaluation of the ten-year effect of implementing national basic public health services in Shanghai |
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| Affiliation: | School of Public Health,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China |
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| Abstract: | Objective Since Shanghai began to explore the establishment of the system of basic public health services in 1997, it has gradually established and improved a network system of basic public health services. By combing the data of basic public health services in the past ten years, we can obtain a general understanding and grasp of the implementation effects of Shanghai's basic public health services. What's more, by summarizing the characteristics of Shanghai's basic public health services, we could put policy suggestions forward for more effective provision of health services in the later period. Methods Data on the implementation of basic public health services in Shanghai from 2009 to 2019 were collected. Through the annual longitudinal analysis, the icons which could directly reflect the specific changes and the overall trend of various indicators in the past ten years were obtained. The Wilcoxon rank test was used to compare the city's comprehensive promotion of family doctor system before and after the index value difference. Results The number of national basic public health services implemented by Shanghai had always been 100% over the years. In the past ten years, the number of residents filing health records had increased year by year to 19.920 1 million. The number of services for key management objects such as women and children, patients with hypertension and diabetes mellitus all reached the level required by the state. The maternal mortality rate dropped to 3.51/100 000, and the infant mortality rate dropped to 3.06‰. The management rate of children's health reached 98.47%. The management rates of hypertension and type 2 diabetes mellitus were 84.77% and 87.37%, respectively. Wilcoxon rank sum test showed that the implementation of the family doctor system was due to the reduction of maternal mortality, the decrease of infant mortality and the improvement of early pregnancy registration rate, postpartum visit rate, blood pressure control rate of hypertension management population, etc. The differences were statistically significant(all P<0.05). Conclusion Shanghai has achieved remarkable results in the implementation of basic public health service projects, but it still needs to be improved in the standardization of electronic health records, the supervision and assessment mechanism of public health funds, and the strengthening of the introduction of public health service personnel. |
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