| 1 BackgroundIn 2003 the incidence of atypical pneumonia epidemic,exposing China's disease prevention and control system,there are many deep-seated problems,the CPC Central Committee and the State Council explicitly put forward the public health system to strengthen the building of the goals and tasks,and strive to three years to build basic urban and rural coverage,Improve the function of disease prevention and control system. To achieve this goal,the state has adopted a series of important measures in a comprehensive and systematic system for disease prevention and control work.Shanghai municipal government formulated the "2003 Shanghai to strengthen the building of public health action plan(2003-2005)",the District Government has formulated a three-year action plan accordingly, to strengthen disease prevention and control system,rationalize the management of public health System,and effectively deal with public health emergencies is the key element of the building.District Disease Prevention and Control Center for Disease Control and Prevention is the main component of the system.How to evaluate systems for Disease Control and Prevention Centre,2003 construction progress, Analysis Centre building is expected to reach the target level,the construction of the Centre for Analysis of the existing problems and challenges facing the scientific management and scientific decision-making needs,but also to consolidate,develop disease Prevention and control system and improve the results of building construction of a system's needs.2 ObjectiveThe purpose of this study is on the current health reform and development goals and priorities,using the census form,the disease prevention and control institutions of the region's socio-economic situation and the Centre for the allocation of resources,ability to work,the implementation of duties,the effectiveness of social Andthe impact on the process of in-depth understanding and analysis,evaluation District Disease Prevention and Control Center three years to reach the goal of building,construction of the original three-year evaluation of the degree of resolve,including human resources,funds,equipment, construction equipment,The ability to work,to further strengthen disease prevention and control centers and provide an objective basis.3 Methods3.1 Unified training investigators,forms of unification,the choice of 19 districts and counties of the Centers for Disease Control conducted the census.For more information on the recovery of the survey form after the initial screening by the computer entry,data processing and statistical analysis,to understand a logic error or mistake of further verification, until the correct to use;results of the analysis of district and county Organizations,director of the Center for Disease Control and Prevention and On a forum of experts.3.2 Research content3.2.1 Disease Prevention and Control Center allocation of resources, including manpower,funding,facilities,equipment four parts.3.2.2 Disease Prevention and Control Center capacity-building,the ability to select the emergency,laboratory testing capacity,applied research capacity as the main content of evaluation.3.2.3 Disease Prevention and Control Center implementation of public functions.3.2.4 all sectors of society and government and relevant departments of the disease prevention and control system building and evaluation of the work situation.4 Research results4.1 District of Shanghai Disease Prevention and Control Center three years building the allocation of resources Analysis4.1.1 staff analysisAfter three years of construction,the Shanghai Center for Disease Control and Prevention District officers in 2002 increased by 2.5%,the average per agency staff in the post graduate students,college, specialist in Shanghai accounted for 62.7 percent ratio,higher than the 60.3 percent of the city,the county 43.7%.The prevention of a professional medical specialty ayerage of 49.2 percent,clinical,medical technology category accounted for 31.8%of the medical profession with the municipal,county average,preventive medicine,clinical medicine category Shanghai districts and counties averaged 81.7%of the body, Higher than the national municipal accounting for 67.1 percent, accounting for 68.6 percent of the county level.Title distribution,the city's districts and counties are senior institutions of the average 0..8 percent,accounting for 5.5 percent of senior,intermediate accounting for 26.1 percent,Assistant(junior/ division) 42%,10.4%of the class members,accounting for 15.2 percent without titles.High,middle and junior officers of 0.7:3.1:6.In 2005 the average age of 40.4 years of age,21.5 years in the disease control work.Qualifications,professional pose more of the optimization,4.1.2 Investment Analysis2005 Shanghai Center for Disease Control and Prevention District total revenue of 338 million,an increase of 2002 over a 62.4 per cent; per workers,services per million population per million population occupy the household registration for Disease Control and Prevention cost of 157,000 yuan,respectively,18.7 million.250,000 yuan,representing an increase of 2002 were 58.5%and 46.1%,59.1%.One county government finances allocated a total of 260 million,095 million more in 2002 increased by 173.7 percent;average of district and county government funding for Disease Control and Prevention Center income of 77%compared to 2002 increased by 68.4%.District Disease Prevention and Control at the same level of financial allocation of local fiscal expenditure ratio imbalance between the districts and counties to a maximum of 0.5 percent, the lowest only 0.1%of these two districts and counties in 2002 were down a percentage point 0.08,0.05.Prevention services revenue continues to rise,in 2002,an increase of 31.3 percent,10 districts and counties which have lower than average, the lowest for 2.61 million yuan,four districts and counties decreased trend,the rate dropped 42.6 percent to 4.7 percent between fluctuations.4.1.3 housing construction situation analysis2005 Shanghai Center for Disease Control and Prevention District Housing agencies in fixed assets(including construction) of the average investment for every 036 million yuan,of which 029 million yuan of urban, suburban 031 million yuan over the 2002 increased by seven times,eight times;Higher than the urban suburbs.Work space and work space built in every area of 6185.4 square meters building institutions,trade unions work space 54.7 square meters per capita,than in 2002 respectively,an increase of 61%,57.6%.Than the city,county disease prevention and control center space per capita level area of 62.5 square meters,the county 51.1 square meters,Shanghai districts and counties in per capita area of space below the city(prefecture) level,above the county level; national sample areas of disease prevention Two agencies control the cities and counties self-unit housing construction funds accounted for more than 25 percent of the Shanghai financial district and county construction projects are funding. Shanghai Center for Disease Control and Prevention District experimental space agency anaverage of 1371.4 square meters for each agency,or work space area of 28.3 percent,12.1 square meters per capita experimental space;than the 2002 rate of increase was 23.7%,8.6%,20.7 %.Than the city,county Center for Disease Control and Prevention laboratory space area per capita were 21.5 and 13.8 square meters lower. Laboratory space agencies of the proportion of total construction area, the city is 22.7 to 29.9 percent,22.7 to the county level to the level of 25.9 percent,Shanghai districts and counties of experimental space area and the percentage of the work space of the city level Standards, higher than the county level.4.1.4 analysis of laboratory equipmentAfter three years of construction,2005 Shanghai Center for Disease Control and Prevention District average total fixed assets for 042 million yuan of which,038 million yuan for urban,suburban 047 million yuan, representing an increase of 2002 were 3.5 times and 5.5 times,2.9 times. Each agency laboratory equipment for the average 6.195 million yuan,of which 4.092 million yuan for urban and rural areas to 7.992 million yuan, representing an increase of 2002 were 131.1 percent and 121.5 percent, 183.7 percent.Showed the absoiute value is greater than the outskirts of urban characteristics.Although all levels of disease prevention and control center equipment configuration number has been greatly improved, targeted more perfect,but for "provincial,and county-level disease prevention and control institutions main laboratory equipment standards", and the prefectural level 13530000 Yuan,the county 4.1 million yuan, close to the outskirts of the municipal standards compliance rate was 88.6%,urban municipal standards only 53 percent.The average number for each body 588.9 kinds of equipment.For 397 kinds of urban and rural areas to 804 kinds,in 2002,an increase of 49.5%, 79.3%,29.0%.In absolute terms the outskirts of urban areas is two times, the number of rural areas than urban facilities may be due to more rural areas of production enterprises,prevention and treatment of occupational diseases monitoring equipment relatively more of it.But with national standards and equipment requirements of the(city) level,274 kinds of comparison,the overall average level of more than 214.9 percent,of which the urban standard of 144.9 percent ultra,ultra-suburban standards 293.7 percent.4.2 District of Shanghai Disease Prevention and Control Center of capacity building4.2.1 emergency response capacity2005 district disease prevention and control institutions to dispose of emergency items should be disposed of the events of the project for the proportion of 90.5%compared with 2002 increased by 58.3%.91.2%of urban and rural areas 89.7 percent.Total handle emergencies in 2005,268 incidents,an average of 17.9per institutions,and in 2002,an increase of 51.4 percent.Improve the emergency mechanism,organizations,institutions, disease prevention and control division of functions and coordination of emergency response mechanisms,plans and technical programmes such as building a total of 14 indicators improved greatly increase the degree, seven in more than 99 percent,the lowest rate of experts set up the Up 58.8 percent,compared with the rate in 2002 increased 14.6 to 352.2 percent.Every agency contingency professional teams have 52.6,1.3 days per person in training,to organize emergency drills 4.1 times respectively over 2002 an increase of 137.1 percent,97.2 percent,241.7 percent.2005 public health emergencies monitoring frequency and the number of emergencies reported six more in 2002 monitoring report in the rate of increase of 6.3-266.7%,including disease prevention and control the epidemic found the bodies of conventional public health emergencies of the number of relevant information and take the initiative to monitor Information found the number of each agency were an average of 2.5 times and 1.1 times.4.2.2 experimental test analysis2005 average per item inspection of all institutions havethe capacity to 196,necessary to carry out 97 projects,covering all project-level disease prevention and control centers testing the ability of each agency standards for the average 44.8 percent,45.1 percent of urban and rural areas 40%A maximum of 73.7 percent,the lowest was 30.9 percent.Covering essential items-Disease Prevention and Control Center tested the ability of each agency standards for the average 60.1 percent,60.2 percent of urban and rural areas 54 percent and a maximum of 82.4 percent,the lowest was 45.3 percent,A 2002 test items to increase the rate of all items, essential items were the highest growth rate of 128.2 percent,76.4 percent,a decline of the two areas,all of the decline rate was-1.6%, -0.2%;essential items Is a decline,the rate dropped to -1.0%.Than the national average in 2005 to carry out the municipal and 168 county level to carry out an average of 81,respectively,more than 32,115.4.2.3 Applied Research AnalysisBy 2003 the building of the Shanghai Center for Disease Control and Prevention District commitment to and participationin research projects related to the higher level of project number increases every year,an average of 2002 samples of each district disease prevention and control institutions project 5.1,2005 increased to 8.5 in 2005 compared 2002 project of the maintenance level of 57.9 percent unchanged,the increase of 31.6%.The average disease prevention and control institutions published in papers 25.8,in 2002,an increase of 47.4 percent.4.3 Disease Prevention and Control Center implementation of public functionsCDC-class districts and counties to perform the function of the functions of the seven major projects in the situation analysis,carried out in 2005 was 80.4 percent compared with 2002 increased by 0.2 percentage points. Carry out the functions of living in the top three health education,public health emergencies to deal with emergencies,health-related factors and disease information management,the functions carried out between 2002 than the rise in the rate of the epidemic and a health-related factors information management,health education And health promotion, respectively,an increase of 42.7 percent,0.6 percent;rest of the decline in varying degrees,mainly for Disease Control and Prevention, public health emergencies to deal with emergencies,laboratory testing and evaluation,respectively,a decrease of 8.1%,4.3%,4.1%.In a public function in terms of the project,launched in 2005 the overall level of 82.1 percent compared with 2002 increased 52.9 percent. Than among the various functions undertaken in 2002 in both the extent to which the top three of the Habitat health hazards monitoring and control, laboratory testing and evaluation,health-related factors and disease information management,respectively,an increase of 45.3%,35.7%,28.8%.In the completion of the project have been undertaken in terms of analysis,completed in 2005 the overall level of 66.0 percent compared with 2002 increased 24.8 percent.Than among the various functions undertaken in 2002 in both the level of increase is the epidemic of abode in the top three health-related factors and information management, health hazard monitoring and intervention factors,laboratory testing and evaluation,respectively 83.9 percent and 43.5 percent,29.9 percent.4.4 Government and the relevant departments on disease prevention and control system-building and institutional job evaluation of the situation Government is responsible for public health,strengthen leadership over the previous increase the intensity.Government departments such as the National People's Congress approved this rate was 100 percent,disease prevention and control institutions to 89.6 percent,76.1 percent higher than the national level which the evaluation of the urban outskirts of the CPPCC National People's Congress no difference in disease prevention and control institutions rating higher than that of urban suburbs, increasing the degree of Score the former accounting for 78 percent of the total score,which accounted for 65 percent,higher than the score of urban suburbs.The public understanding and participation in the degree of social coordination of the health sector in disease prevention and control cooperation mechanism.Government departments such as the National People's Congress on the public to understand and participate in the improvement of recognition rate was 97.2%,disease prevention and control institutions to 100.0%,93.2%higher than the national level.Improve the level of the total score of 76.0 percent,the public understanding and participation in the building than three years before the increase. Disease prevention and control institutions to further clarify the functions of public recognition rate was 94.2%,92.8%higher than the national level.Government,the National People's Congress and CPPCC National Committee,health administrative departments,such as disease prevention and control of the public functions of the recognition rate was 78.2 percent,84.7 percent higher than the urban outskirts of 72.6 percent,the lowest 25.0 percent;disease prevention and control work on the understanding reached 74.4 percent,Of which 80.6 percent higher than the urban outskirts of 69.0 percent,the lowest 25 percent of disease prevention and control institutions of public functions and disease prevention and control work to understand the situation are higher than the national ratio of 63.5%,63.4%.That Government's commitment to public functions,disease prevention and control agencies of the mechanism than three years before the building of the increase accounted for 98.2 percent,investment accounted for 73.2 percent of stability,there are still gaps in accounting for 67.8 percent; than that of the country have increased 94.5 percent,Investment accounted for 93.6 percent of stability,the gap accounted for 34.9 percent, Shanghai districts and counties in addition to the degree higher than the national increase in stability,there are gaps in both lower than the national level.The Government of disease prevention and control agencies of the basic implementation of separation between revenue and expenditure, the zero-base budget,and to reform the investment mechanism according to the requirements of project management,on the basis of the quantity and quality of the situation to allocate and share the disease prevention and control institutions with funds linked to the work Accounted for 59.2%, 26.3%higher than the national ratio.97.2 percent have the disease prevention and control centers that work with funding linked to the reform will help improve disease prevention and control the work efficiency, authorized level higher than the national ratio of 93.6%.66.4%of disease control agencies of the personnel reform of the distribution system,higher than the national ratio of 29.2%.Gradually non-public goods and services projects and disease prevention and control institutions accounted for 59.9 percent of the stripping,higher than the national ratio of 18.0%.Disease prevention and control institutions began to return to government functions,and provide public products and services of the track.After three years disease prevention and control System for disease prevention and control institutions and the work of "atypical pneumonia" before the incident,the county government,the NPC and the CPPCC,health administrative departments in charge of the leadership,97.2 percent of the respondents think that disease prevention and control work More improvement,improvement of scoring rate was 76.0 percent.100.0%of the disease prevention and control institutions public health emergencies response capacity to improve the rate of 77.0 percent scoring rate,97.2 percent sure the technical level and capacity to improve services,improve the level of scoring rate was 76.0 percent,91.7 percent of the people certainlybenefit,the beneficiary Degree scoring rate was 71.0 percent.5 Discussions and recommendations5.1 Disease Control and Prevention slight increase in the number of personnel,improve the quality of personnelImprove the allocation of human resources is a long process.Shanghai districts and counties of Disease Prevention and Control Center over specialist staff ratio is higher than the national municipal and county level.Preventive medicine,clinical medicine category higher than the national ratio of city and county level.However,districts and counties of Shanghai Disease Prevention and Control of Human targeting the status quo,mutatis mutandis,national disease prevention and control reference standards of human resource allocation,there are still large gaps. Designation remains below the national standard;2003 prompted the building of the achievements we have to always focus on the optimization of human resources for Disease Control and Prevention to strengthen the capacity building,focused on solving the standard configuration and personnel access standards and a clear standard time limit;It is necessary to formulate attract,retain,and stability of the personnel measures and methods,increase the intensity of reform,optimize the existing human resources.5.2 financial situation has improved substantially increase financial inputImpact on investment for disease prevention and control the quality and effectiveness of personnel and restrict the introduction and optimization.Shanghai Center for Disease Control and Prevention District for a substantial increase in investment,but look at district and county disease prevention and control institutions source of income,service income accounted for 61.3%,37.6%higher than the national level,in order to maintain the survival of paid services agency still has not eliminated, yet To achieve the full allocation.Different gaps still exist between districts and counties.How to further establish and improve long-term stability of the government investment mechanism,completely stripping disease prevention and control institutions of paid services need to strive for.To that end should continue to intensify disease prevention and control work of the inputs,inputs to public funds and regular operating funds tilt;region to establish the level of economic development and strengthen macro-control the city proper long-term stability of balanced public finances reflected the Government's input mechanism,And municipal finance through the financial transfer payment to strengthen the economy in underdeveloped regions disease prevention and control institutions of input,"11th Five-Year Plan" period the Shanghai government financial and health system still need further research to explore the theme of the next round of Disease Control and Prevention The focus of construction of a system.5.3 Housing construction increased,laboratory equipment,a substantial increase 2005 Shanghai Center for Disease Control and Prevention District Housing agencies in fixed assets(including construction) than in 2002 increased by seven times,eight times.Work space and work space in the building construction area in 2002,an increase of 61.0%,57.6%.And 2002 than the business space,laboratory space for a slight increase in work space,administrative space,the protection of space declined slightly.2003 Ministry of Health and Disease Prevention and Control system for the research group on the proposed county-level standards,the experimental space area of standards;other features both houses,occupation of the premises in particular.Agencies also need to monitor the actual situation and appropriate adjustment of the ratio of a space.After three years of construction,2005 Shanghai Center for Disease Control and Prevention District average total fixed assets,an average of every institution of the value of equipment,equipment in both institutions increased significantly.But in absolute terms the number of devices the outskirts of urban areas is two times,may be more suburban enterprises,prevention and treatment of occupational diseases monitoring equipment relatively more of it.How to give full play to equipment performance,better for the smooth development of disease prevention and control work to provide services,the Shanghai districts and counties in disease prevention and control institutions need to give concern to one aspect.5.4 Disease Control and Prevention enhance service capabilities,to improve the capacity of public functionsDistrict disease prevention and control institutions to dispose of emergency projects to increase,improve emergency response mechanisms, emergency teams and professional training has increased,emergency reserves had increased the variety and value.2005 frequency of monitoring public health emergencies and unexpected events than the number reported in 2002 increased significantly.District disease prevention and control institutions can grasp the basic public health emergencies of the dynamic potential source of risk,timely detection,reporting,forecasting,and the report of the incident timely disposal capacity has been improved, public health emergencies of the early warning mechanism for monitoring Formation.But unexpected events still not 100 percent effective disposal, should continue to strengthen emergency emergency allocation of resources and personnel training,emergency norms,improve the health emergency response capacity.All test items and institutions essential items had increased,higher than the national average in 2005 and municipal projects can be carried out. District of test items in urban areas was higher than the suburbs,the counties have varying degrees of increase.By 2003 the building of the Shanghai Center for Disease Control and Prevention District commitment to and participation in research projects related to the higher level of project number and published several papers increased year by year. District Disease Prevention and Control Center to carry out the seven-level functions of the projects carried out rate,projects related to the overall level of completion of the project than 2002 have an average annual increase.But to carry out test items and also a wide gap between the national standard;degree of public functions completed only 66.0 percent.Should continue to strengthen the laboratory staff training and improve the capacity of laboratory tests,and increase public functions to the extent and degree completion.5.5 function of the clarity,further improve the operational mechanism, to further improve the social imageDisease prevention and control institutions of public functions further clarity,the Government,the National People's Congress and CPPCC National Committee,health administrative departments,such as disease prevention and control of the public functions of the authorized rate of disease prevention and control institutions of public functions and disease prevention and control work has increased understanding of the situation.Tips for disease prevention and control of their own public functions have been more clear positioning.However,the Government and people of all walks of disease prevention and control functions and also the work of the authorized level is not high enough,this will have an impact on disease prevention and control agencies to effectively carry out their functions and carrying out work,for ways to strengthen disease prevention and control of image-related publicity and do a good job Work is under further construction of a system should earnestly consider.
|
PDF Full Text Request