新时期我国基层公共卫生服务发展现况与展望

随着国家经济社会发展，人群患病特征和卫生需求发生规律性改变。提升基层公共卫生服务能力，有助于改善人群健康，降低卫生费用。全国卫生与健康大会上提出新时期卫生工作要把“以基层为重点”放在首位。因此，本文聚焦基层公共卫生服务，并着重从慢性病管理、健康管理及基层卫生应急三大内容开展梳理，分别提出当前基层卫生需求存在着慢性病疾病负担增加、主动健康管理的卫生需求拓展以及疫情防控基层卫生需求提升这三大现况，对基层公共卫生管理提出了新的挑战。通过梳理当前基层医疗卫生服务现况，发现当前在慢病管理方面管理形式丰富，但存在一级预防管理滞后、信息化建设迟缓等问题。在主动健康管理方面存在发展水平有限、管理流于形式、基层人力资源紧张等问题。在卫生应急方面存在常态化疫情防控“事前”控制能力弱等问题。本文通过比较分析，针对两者主要矛盾和差距，提出要以慢病管理为核心，拓宽健康管理边界，丰富基层卫生资源，适当向公共卫生管理领域倾斜，提升工作积极性，推进信息化手段和平台建设，充分放大健康大数据效能，提升人群自我健康管理主动性，完善基层卫生应急响应政策法规和预案建设，改善应急效能的建议，以期提升新时期我国基层公共卫生服务能力，更好地服务“健康中国2030”战略目标。 

The current situation and prospect of the primary public health services in China in the new era

With the development of the economy and society, the disease characteristics and its corresponding health needs have changed. Improving the capacity of primary public health services will help improve people ' s health and reduce health expenditure. At the National Health Conference, it was proposed that the health work in the new era should "focus on the primary health". This paper focuses on primary public health service, especially the chronic disease management, health management and primary health emergency. There are three main current health demand situations: the increase in the burden of chronic diseases, the expansion of health needs for active health management, and the increase in primary health needs for epidemic prevention and control which bring new challenges to primary public health management. We analyzed the current situation of primary medical and health services and found several problems. Firstly, the primary health service institutions take several management measures on the chronic diseases management but still remains problems like the lagging primary prevention and management of chronic diseases and lagging information system construction. Secondly, in terms of active health management, there are problems such as limited development level, formalistic management, and shortage of human resources at the primary health service institutions. Thirdly, concerning the health emergency management, there are weak "before control" capabilities for pandemic prevention and control. With the comparing and analysis, we introduce the importance of construction in these field and the current status. Based on the main contradictions and gaps between the demand and supply, we propose to take chronic disease management as the core, widening the boundaries of health management, enriching primary health resources, appropriately tilt to the field of public health management, enhancing enthusiasm, promoting the construction of informatization system and platforms, fully amplifying the effectiveness of big data on health improving the self-health management initiative of the population, completing the construction of primary health emergency response policies, regulations and plans to improve emergency response efficiency. With all these measures, we intend to enhance primary public health service capabilities in the new era and achieve the "Healthy China 2030" strategic goal.