四川省疾病预防控制系统慢性病防控机构基础配置现状及公平性研究

目的了解四川省疾病预防控制系统慢性病防控部门、人力、财力等基础配置资源的现状及其人口分布和地理分布的公平性。方法采用问卷调查方法,收集四川省市(州)和县(区)级所有疾病预防控制中心(CDC)慢性病防控的部门设置、人力资源和经费配置等信息。同时,收集各市(州)2009年人口数和地理面积,利用洛伦茨曲线和基尼系数测算公平性。结果部门设置:市(州)级和县(区)级CDC设有专门慢性病防控科所的比例分别为14.29%和1.65%,设置以慢性病防控为主要职责的科所比例分别为9.52%和4.40%。人力资源:全省慢性病防控人数、专职慢性病防控人数占CDC总人数的比例分别为3.88%和1.23%;33.9%的慢性病防控工作人员接受过本科及以上教育;94.2%的人员具有医学背景;9.7%的人员有高级职称;76.1%的人员从事慢性病防控工作年限在5年以下;85.8%的慢性病防控工作人员所在部门不以承担慢病防控为主要职责,仅承担本单位慢病防控相关工作。经费配置:市(州)级和县(区)级CDC慢病防控经费占同级CDC总业务工作经费的比例分别为1.14%和0.91%。资源公平性:慢病防控科所、慢病防控人员、专职慢病防控人员和慢病防控经费按人口配置的基尼系数分别为0.646、0.287、0.355和0.421,按地理面积配置的基尼系数分别为0.902、0.551、0.733和0.761。结论四川省疾控系统慢性病防控专职部门所占比例较少,人员数量不多,经费投入不足,基础配置仅部分考虑到了人口公平性,地理面积配置方面存在严重不公平状态。

Status and Equity of Infrastructure for Chronic Noncommunicable Diseases Prevention and Control Institutions in Sichuan System for Disease Control and Prevention

Objective To understand the status and the demographic and geographic equity of infrastructure in terms of institutional,human and financial resources for noncommunicable diseases(NCD) prevention and control in the Centers for Disease Control and Prevention(CDCs) in Sichuan province.Methods All city and county CDCs in Sichuan province were surveyed by quesetionnaires on institutional,human and financial support.The population and geography information in 2009 were collected at the same time.The equity was calculated by Lorenz curve and Gini coefficient.Results At city and county level,the proportions of CDCs that had professional institutes of NCDs were 14.29% and 1.65% respectively,and had institutes mainly responsible for NCDs prevention and control were 9.52% and 4.40% respectively.General and professional staff on NCDs prevention and control accounted for 3.88% and 1.23% of all the CDCs’ personnel.There were 33.9% of the staff members had educational background of college undergraduate or higher,94.2% had medical educational background,9.7% had senior professional titles,76.1% of them worked for NCDs less than 5 years,85.8% of them worked in institutes not mainly responsible for NCDs prevention and control.Funds for NCDs prevention and control only accounted for 1.14% and 0.91% of the total funds of city and county CDCs,respectively.The demographic Gini coefficients of institute,staff,professional staff and funds on NCDs prevention and control were 0.646,0.287,0.355 and 0.421,respectively,and the geographic Gini coefficients were 0.902,0.551,0.733 and 0.761,respectively.Conclusion Professional institutes,staff members and fundings for NCDs are quite limited in Sichuan CDCs.The infrastructure allocation are partly equitable according to distribution of population,but highly inequitable according to distribution of geographic area.