“罗湖医改”模式下新冠肺炎社区防控及效果评价

Evaluation on medical alliance-based community prevention for coronavirus disease 2019 in Luohu district of Shenzhen city:a comparison analysis

目的探讨"罗湖医改"模式下新型冠状病毒肺炎(COVID-19)的社区防控开展情况,并进行初步评价。方法采用描述性流行病学方法对深圳市罗湖医院集团社康和罗湖区部分民办社康联合体即康君联合体社康的COVID-19的监测和居家隔离情况进行分析,并通过对比分析深圳市其他区COVID-19的发病传播情况,评价"罗湖医改"模式下罗湖医院集团社康COVID-19的社区防控效果。结果 2020年1月8日—2020年3月2日,罗湖医院集团社康COVID-19监测排查34 625人,康君联合社康监测排查19 317人,相对于各自的服务人口数差异有显著统计学意义(χ~2=440.90,P <0.001);罗湖医院集团社康纳入居家隔离人数为6 077人,康君联合社康纳入居家隔离人数为3 229人,相对于各自的监测排查人数差异有统计学意义(χ~2=6.06,P <0.05)。在纳入居家隔离的及时性上,罗湖医院集团社康居家隔离人群的返深时间与纳入居家隔离时间间隔为(2.31±5.08)d,而康君联合体社康的时间间隔为(5.32±6.29)d,差异有统计学意义(t′=23.42,P <0.05)。罗湖医院集团社康累计居家隔离人数高峰期是2月1日,比康君联合体社康早4 d,比深圳市密切接触者的管理人数高峰期早7 d。同时罗湖区在2020年2月14日—3月2日,COVID-19病例零增长,深圳市其他区还有波动。结论在"罗湖医改"模式下,罗湖医院集团社康的新型冠状病毒肺炎社区防控相对于罗湖区部分民办社康联合体社康即康君联合体社康监测排查更加严格,纳入居家隔离更加及时,同时COVID-19的发病情况相对于深圳市其他区更早实现零增长。

Objective To briefly report and preliminarily evaluate medical alliance-based community prevention and control for coronavirus disease 2019(COVID-19)epidemic in Luohu district with the implementation of medical reform characterized by the construction of medical alliances and hierarchical diagnosis and treatment system(namely Luohu medical reform)in 2015.Methods We collected the data on COVID-19-related surveillance and home quarantine among two groups of community residents in Luohu district of Shenzhen city during the period from January 8 th to March 2 nd,2020.The two resident groups were covered by community health service centers(CHSCs)attached to a public hospital group under medical reform administration(PHG)and a civilian-run privacy medical institution group(CRG),respectively.Descriptive and comparative statistics were performed to analyze COVID-19-related surveillance and home quarantine of the two residents groups.Results During the period among the residents covered by CHSCs attached to PHG,totally 34625 high-risk individuals(6.22%of the whole residents)were surveyed for detecting COVID-19 infections,of which,6077 were quarantined at home;while,among those covered by CHSCs attached to CRG,19317 high-risk individuals(5.18%of the whole residents)were surveyed and 3229 were quarantined at home;there were significant differences in the ratio of the individuals surveyed(χ~2=440.90,P<0.001)and quarantined(χ~2=6.06,P<0.05)between the two resident groups.For the individuals quarantined due to the history of travelling in regions with COVID-19 epidemic,the mean interval from retuning home to being quarantined was significantly shorter for the individuals covered by CHSCs attached to PHG than for the individuals covered by CHSCs attached to CRG(2.31±5.08 days vs.5.32±6.29 days,t′=23.42;P<0.05).The date with the highest number of residents being quarantined was 4 days earlier among the residents covered by CHSCs attached to PHG than among those covered by CHSCs attached to CRG.Conclusion With the implementation of medical reform in Luohu district of Shenzhen city,the prevention and control for COVID-19 epidemic was much more effective in communities covered by community health service centers attached to the public hospital group than in communities covered by community health service centers attached to other medical alliances.