新型冠状病毒肺炎疫情期间武汉市发热门诊运行机制及防控策略分析

 目的 发热门诊是做好传染病防控的第一道关口，通过总结分析新型冠状病毒肺炎（简称新冠肺炎）疫情下武汉市发热门诊运行中遇到的问题和难点，据此探讨我国发热门诊的运行机制和疫情防控改进方向。方法 调查2020年1月15日—3月15日武汉市所有开放发热门诊的医疗机构每日发热门诊就诊数据，结合国家、湖北省以及武汉市发布的应对新冠肺炎疫情防控和救治有关通知、政策及文件等信息，回顾和评价新冠肺炎疫情期间武汉市发热门诊就诊和运行情况。结果 调查期间武汉市先后部署共计76所二级及以上医疗机构开放发热门诊收治发热患者。2020年1月15日—3月15日武汉市发热门诊平均每日就诊量为6 070人次。1月15日发热门诊就诊量为1 625人次，1月24日达到顶峰（14 486人次）。1月30日—2月6日武汉市发热门诊接诊量几乎饱和。2月6日开始，就诊量呈现逐步下降趋势，3月15日降至585人次。武汉市中心城区的7个行政区中除洪山区外其他6个行政区日均就诊量均在千人以上，武昌区发热门诊就诊量普遍高于其他区域。结论 武汉市发热门诊在疫情期间未能充分发挥早期预警作用，在人员、物资和设施的配备等方面存在问题。医疗机构应从建立平战结合的公共卫生预警反馈机制、构建科学的一站式发热门诊、建立医疗应急供应保障体系以及组建复合型公共卫生应急队伍等四个方面优化发热门诊建设和管理，制定科学有效的疫情防控策略。

Operation mechanism as well as prevention and control strategy of fever clinics in Wuhan during COVID-19 epidemic outbreak

Objective Fever clinic is the first threshold to prevent and control infectious diseases, based on the summary and analysis on the problems and difficulties in the operation of fever clinics in Wuhan City during epidemic of coronavirus disease 2019 (COVID-19), operation mechanism of fever clinics as well as prevention and control improvement direction of epidemic in China were evaluated. Methods Daily visit data in all fever clinics in medical institutions in Wuhan were surveyed from January 15, 2020 to March 15, combined with the information related to notification, policy and document about prevention and treatment for COVID-19 epidemic issued by China, Hubei Province and Wuhan, visits and operation in fever clinics in Wuhan during COVID-19 epidemic period was retrospectively reviewed and evaluated. Results During the survey period, a total of 76 secondary and above medical institutions in Wuhan opened fever clinics to receive and cure fever patients. From January 15 to March 15, 2020, the average daily number of visits in fever clinics in Wuhan was 6 070 person-time. The number of visits in fever clinics was 1 625 person-time on January 15 and peaked on January 24 (14 486 person-time). From January 30 to February 6, the number of visits in fever clinics in Wuhan was almost saturated. Since February 6, the number of visits showed a gradual downward trend, and dropped to 585 person-time on March 15. Except Hongshan Region, the average daily numbers of visits in the other 6 administrative regions in downtown area of Wuhan were all more than 1 000, the number of visits in fever clinics in Wuchang Region was generally higher than other regions. Conclusion During the epidemic period, fever clinics in Wuhan failed to give full play to the role of early warning, and there were problems in equipment of personnel, materials and facilities. Medical institutions should optimize the construction and management of fever clinics from the following four aspects: establishing a public health early warning feedback mechanism, building scientific one-stop fever clinic, establishing medical emergency supply guarantee system and setting up compound public health emergency team, so as to formulate scientific and effective epidemic prevention and control strategies.