从系统论看我国公共卫生体系建设 要求与差距

Formation, requirements and differences of public health system in China on systems analysis

目的 :探讨高效公共卫生体系的理论要求及我国现有公共卫生体系与这些理论要求间的差距。方法 :我们在充分的文献复习及深入的问询与座谈的基础上 ,运用软系统分析方法构筑高效公共卫生体系的理论框架 ,并对照该框架检查现有公共卫生体系存在的问题。结果 :我们提出了由“目标规划、基础设施、信息系统、决策指挥和控制措施”五大相辅相成要素构成的公共卫生体系模型 ,并对比分析了我国现有公共体系在这五个方面所存在的主要问题与不足。结论 :从系统角度看 ,我国现有公共卫生体系从“目标规划”到“控制措施”的每个方面都有很多需要改进的地方 ,尤其是“目标规划”、“信息系统”及“决策指挥”方面更显得有些薄弱。

Objectives:This paper discusses requirements of effective public health systems from a systematic point of view and examines problems existent with public health systems in China.Methods:Based on somewhat thorough literature review and a series of interviews and group discussions of key informants,we derived theoretical framework using soft systems thinking first and then examined existing public health systemsss in China accordingly.Results:Atheoretical framework was put forward consisting of planning,infrastructure,information, decisionmaking and stewardship,and control and specific problems with China public health systems in each of these areas were identified. Conclusion:Problems exist in each component of China public health systems and the gap between the desirable and actual conditions is especially significant in areas as planning, information system and decisionmaking and stewardship.