国家基本公共卫生服务项目十年评价(2009—2019年)系列报告(三)——国家基本公共卫生服务项目实施十年:挑战与建议

National Essential Public Health Services Programs over the Past Decade Research Report Three:Challenges and Recommendations of Implementation National Essential Public Health Services Programs over the Past Decade

国家基本公共卫生服务项目作为深化医药卫生体制改革的一项重要措施,已开展十余年。因此评估该项目实施十年(2009—2019年)的效果和尚存的问题,对进一步推进国家基本公共卫生服务意义重大。本文参照Donabedian质量理论,从项目目标、项目内容、运行机制、实施过程、产生效果等方面,总结并分析当前我国基本公共卫生服务仍存在的关键问题,并从六方面提出了相关建议,主要为:基于科学论证,动态调整项目;建议国家基本公共卫生服务进行分级、分类管理;适时修订项目规范,促进服务提质增效;逐步推进以效果为导向的评价考核制度;完善运行机制,促进可持续发展;充分发挥县域医共体作用,加强服务协同;建立科学、长效的国家基本公共卫生服务项目监测机制。以为进一步完善、优化国家基本公共卫生服务项目提供参考。

As an important measure to deepen the reform of the medical and pharmaceutical health system,the national essential public health services programs has been carried out for more than ten years.Therefore,it is of great significance to evaluate the effect and remaining problems of the programs over the decade of implementation period(2009-2019)and to further promote the country's basic public health services.With reference to Donabedian quality theory,this paper summarized and analyzed the key problems existing in China's basic public health services from the aspects of project objectives,project contents,operation mechanisms,implementation processes and effects,and make relevant suggestions from six aspects,mainly as follows:based on scientific reasoning,dynamically adjusting the programs;suggestion that the national basic public health services should be graded and managed by classification;timely revision of project specifications to improve service quality and efficiency;gradually promoting the effectiveness-oriented evaluation and assessment system;improving operational mechanisms and promoting sustainable development;fully playing the role of county medical community,and enhancing service coordination;establishing a scientific and long-term monitoring mechanism for national essential public health services programs.It provides reference for further improvement and optimization of national essential public health services progjects.