中国疾病预防控制体系：2002年至2012年的发展趋势
The Centers for Disease Control and Prevention System in China: Trends From 2002-2012.
作者信息
Li Chengyue, Sun Mei, Wang Ying, Luo Li, Yu Mingzhu, Zhang Yu, Wang Hua, Shi Peiwu, Chen Zheng, Wang Jian, Lu Yueliang, Li Qi, Wang Xinhua, Bi Zhenqiang, Fan Ming, Fu Liping, Yu Jingjin, Hao Mo
机构信息
Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China.
出版信息
Am J Public Health. 2016 Dec;106(12):2093-2102. doi: 10.2105/AJPH.2016.303508.
OBJECTIVES
To assess the improvements of the Chinese Centers for Disease Control and Prevention (CDCs) system between 2002 and 2012, and problems the system has encountered.
METHODS
We obtained data from 2 national cross-sectional surveys in 2006 and 2013, including 32 provincial, 139 municipal, and 489 county-level CDCs throughout China. We performed a pre-post comparative analysis to determine trends in resource allocation and service delivery.
RESULTS
The overall completeness of public health services significantly increased from 47.4% to 76.6%. Furthermore, the proportion of CDC staff with bachelor's or higher degrees increased from 14.6% to 32.6%, and governmental funding per CDC increased 5.3-fold (1.283-8.098 million yuan). The working area per CDC staff increased from 37.9 square meters to 63.3 square meters, and configuration rate of type A devices increased from 28.1% to 65.0%. Remaining problems included an 11.9% reduction in staff and the fact that financial investments covered only 71.1% of actual expenditures.
CONCLUSIONS
China's CDC system has progressed remarkably, enabling quicker responses to emergent epidemics. Future challenges include establishing a sustainable financing mechanism and retaining a well-educated, adequately sized public health workforce.
目的
评估2002年至2012年中国疾病预防控制中心（CDC）系统的改进情况以及该系统所遇到的问题。
方法
我们获取了2006年和2013年两次全国横断面调查的数据，涵盖了全国32个省级、139个市级和489个县级疾病预防控制中心。我们进行了前后对比分析，以确定资源分配和服务提供方面的趋势。
结果
公共卫生服务的整体完整性从47.4%显著提高到76.6%。此外，拥有本科及以上学历的疾控中心工作人员比例从14.6%增至32.6%，每个疾控中心的政府资金增加了5.3倍（从128.3万元增至809.8万元）。每个疾控中心工作人员的工作面积从37.9平方米增至63.3平方米，甲型设备配置率从28.1%增至65.0%。尚存的问题包括工作人员减少了11.9%，以及财政投入仅覆盖实际支出的71.1%。
结论
中国的疾控系统取得了显著进展，能够对突发疫情做出更快反应。未来的挑战包括建立可持续的融资机制以及留住受过良好教育、规模适当的公共卫生工作队伍。
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