云南省卫生监督协管队伍建设现状调查

Investigation on the Team Building of Health Supervision and Coordinationin Yunnan Province

目的了解云南省卫生监督协管队伍建设现状、工作现状及需求,发现工作中遇到的主要阻力和问题并分析原因,为加强和完善当地协管队伍建设提供数据支撑和改进建议。方法通过国家卫生健康监督信息报告系统获取云南省卫生健康监督机构基本情况数据;设计协管信息登记表收集云南省全部县(区)卫生监督协管队伍建设和工作现状数据;采用典型抽样方法抽取样本州(市),对卫生健康监督机构领导、在职在岗人员和协管员开展问卷调查和关键人物访谈,了解其对协管工作的认知、态度及改进建议等。分类资料率的比较采用χ2检验或Fisher确切概率检验,计量和等级资料的比较采用秩和检验,访谈资料采用主体框架法进行质性分析。结果2018年云南省共有卫生监督协管员5525名,每万人口协管员1.14人;16.8%为专职协管员;经费主要来自公共卫生服务中央补助(人均1.7元);2018年共巡查487946次,发现违法线索18245条,信息报告率为52.2%;线索立案601起,占全省查处案件总数的11.8%。工作开展较好的C州专职协管员占比31.9%,高于其他两个工作相对滞后的州(χ^(2)=50.76,P<0.001);C州表示“喜欢协管工作”的协管员占比21.7%,“愿意长期从事协管工作”的协管员占比73.9%,均高于其他两州(H=6.57,P=0.037;Fisher-P=0.002)。各类访谈对象都对卫生监督协管队伍建设的重要性认知良好,目前存在的共性问题主要集中在人员、制度和经费方面。结论云南省卫生监督协管队伍已初步建成,工作量大,工作效果较好。进一步提出接下来增加专职协管员比例、保障经费、改进激励机制、提高社会认可度对完善协管队伍建设非常必要。

Objective To understand the team building,current status and demands of the health supervision and coordination in Yunnan Province,explore the main resistance and problems in the work and analyze the reasons,provide data support and suggestions for improvement in the team building of health supervision and coordination.Methods Basic situation data of Yunnan health supervision agencies was obtained through the National Health Supervision Information Report System,and a registration form was designed to collect information of the team building in health supervision and coordination.Questionnaire surveys and key-person interviews of the leaders,in-service staff and coordinators of health supervision agencies selected by typical sampling were conducted to understand their cognition,attitude and suggestions for improvement of the health supervision and coordination.Differences between groups were tested using nonparametric Kruskal-Wallis H tests for continuous variables and chi-squared tests(or Fisher’s exact probability tests)for categorical variables.Framework analysis for qualitative analysis was conducted for interview data.Results There were 5,525 health supervision coordinators in Yunnan Province in 2018,which was 1.14 per 10,000 people,and 16.8%of them were full-time staffs.The funds were mainly from the central subsidy of public health services(￥1.7 per capita).A total of 48,7946 inspections were done and 18,245 clues were found,with an information reporting rate of 52.2%.A total of 601 clues were filed,accounting for 11.8%of the total investigations around the province.The percentage of full-time staffs was 31.9%in city C,which was higher than that in the other two cities with relatively poor work(χ^(2)=50.76,P<0.001);21.7%of participants from city C indicated that they“liked coordination work”,73.9%were“willing to engage in coordination for a long time”,which were higher than that in the other two cities(H=6.57,P=0.037;Fisher-P=0.002).All kinds of interviewees had a good understanding of the importance of team building in health supervision and coordination.The current common problems mainly focused on staffs,systems and funds.Conclusion The coordination team of health supervision in Yunnan province has been preliminarily established with large and good work.It is necessary to increase the proportion of full-time coordinators,guarantee funds,improve incentives and social recognition to perfect the coordination teams.