云桂传染病防治领域激励机制覆盖程度评价

Evaluation of the coverage of incentive mechanism in the field of infection prevention and control in Yunnan and Guangxi

[目的]分析云南与广西两地2002-2016年传染病防治领域激励机制覆盖程度的变化,探究其变化与传染病发病率之间的关联,为促进云桂传染病防治工作的发展提供参考。[方法]系统收集云南、广西所有在官网信息中公开发布的涉及传染病领域激励机制覆盖的政策文件,摘录形成与相关部门实施奖惩措施有关内容字段,并对其进行赋值量化,计算各类部门激励机制覆盖值以及综合覆盖程度。使用Excel 2016对文本资料进行分类整理、摘录、建立数据库并且描述其变化趋势;利用spearman相关、线性回归分析激励机制覆盖程度与甲乙类传染病发病率的关系。[结果]2002-2016年,云南传染病领域激励机制覆盖程度由42.35%提升至60.08%,激励机制覆盖程度与云南甲乙类传染病发病率呈负相关(r=-0.671,P<0.05),覆盖程度增长对甲乙类传染病发病率下降有显著影响(R^2=0.579,P<0.05);广西传染病领域激励机制覆盖程度由39.81%提升至59.27%,两者间不相关(P>0.05)。[结论]云南、广西两地业务主管部门、专业公共卫生机构、医疗机构已基本覆盖激励机制,基层卫生服务机构激励机制覆盖程度仍然较低,进一步促进激励机制有效覆盖部门、建立健全基层卫生服务机构激励机制是降低传染病发病率的有效途径。

Objective To analyze the changes in the coverage of incentive mechanism in infectious diseases in Yunnan and Guangxi from 2002 to2016,explore the relationship between their changes and the incidence of infectious diseases so as to provide reference for promoting the implementation of infection prevention and control in Yunnan and Guangxi. Methods Systematically collected policy documents involving incentive mechanism in infectious diseases field which were published in Yunnan and Guangxi official website information. It extracted the relevant content of the implementation of rewards and punishment by relevant departments,and conducted assignment quantization,calculated incentive mechanism coverage value of various departments and comprehensive coverage degree. It used Excel 2016 to sort,extract and set up a database,and described their changes trend. It analyzed the relationship between the degree of incentive mechanism coverage and the incidence of Class A and B infectious diseases by spearman correlation and linear regression. Results From 2002 to 2016,incentive mechanism coverage in infectious diseases field increased from 42. 35% to 60. 08%. The coverage of incentive mechanism was negatively correlated with the incidence of Class A and Class B infectious diseases in Yunnan( r =-0. 671,P < 0. 05). It had obvious significance in increasing of coverage degree to decline of the incidence of Class A and B infectious diseases( R^2= 0. 579,P < 0. 05). The coverage degree of incentive mechanism in Guangxi infectious diseases increased from 39. 81% to 59. 27%,which was not correlated( P > 0. 05). Conclusions The incentive mechanism has effectively covered business supervise departments,professional public health institutions and medical institutions in Yunnan and Guangxi. The coverage of incentive mechanisms for grassroots health service institutions is still low. Further The efficient path of reducing the incidence of infectious diseases is that further promote incentive mechanism to effectively cover the departments,establish and improve incentive mechanism in grassroots health service institutions.