基于卫生政策分析的基层医疗卫生机构在新型冠状病毒肺炎疫情防控中的作用研究

Roles of Primary Care in Response to the COVID-19 Pandemic Defined in Policy Documents

背景明确基层医疗卫生机构在新型冠状病毒肺炎(简称新冠肺炎)疫情防控中应承担的任务和职能,是其充分发挥作用的首要前提。目的通过梳理国家卫生健康行政部门自新冠肺炎疫情发生以来发布的相关政策文件,系统总结基层医疗卫生机构在新冠肺炎疫情防控中应该承担的职责和工作任务,为各地开展具体的疫情防控工作提供指导。方法于2021年8月,浏览国家卫生健康委员会及其下设委机关的官方网站,以“基层医疗卫生机构”“基层防控”“新冠肺炎”“新冠肺炎疫情防控”为主要检索词,采集新冠肺炎疫情发生以来国家卫生健康行政部门发布的政策文件。将同时符合“新冠肺炎疫情防控”“基层医疗卫生机构”两个主题的政策文件按发布时间顺序进行梳理,并采用人工精读、分析和总结的方式,对其内容进行整理、归纳。结果共纳入34份政策文件。34份政策文件主要来源于国家卫生健康委员会、国家卫生健康委员会基层卫生健康司、国家卫生健康委员会医政医管局、国家卫生健康委员会疾病预防控制局等官方网站,发文单位主要为国务院应对新冠肺炎疫情联防联控机制、国家卫生健康委员会办公厅、国家卫生健康委员会基层卫生健康司等。政策文件指出,基层医疗卫生机构在新冠肺炎疫情防控中,应承担的主要工作任务包括以下8个方面:病例早发现、早报告;疫情防控知识培训和应急演练;医院感染防控和个人防护;会同社区做好疫情防控工作;科学开展疫情防控健康教育;重点人群的健康管理;核酸检测样本采集和送检;新型冠状病毒疫苗接种。结论基层医疗卫生机构在新冠肺炎疫情防控工作中承担着重要的责任,各地方应该在政策文件精神的指导下,因地制宜,切实发挥出基层医疗卫生机构“网底”作用。

Background The major promise for promoting primary care intuitions to take the initiative to play an active role in containing the COVID-19 pandemic is defining the duties and roles that they should undertake.Objective To review the policy documents related to COVID-19 issued by China's health administrative departments to make a systematic summary of the responsibilities and duties that should be undertaken by primary care institutions,offering guidance for COVID-19 containment in various regions of China.Methods In August 2021,we searched the official websites of the National Health Commission of the People's Republic of China(PRC)and its subordinate institutions for policy documents related to COVID-19 using"primary careinstitutions""prevention and control at the community level""COVID-19"and"COVID-19 prevention and control"as the main search terms.The policy documents containing"COVID-19 prevention and control"and"primary careinstitutions"were sorted out in chronological order of publication,and their contents were intensively reviewed,organized,summarized and analyzed.Results Thirty-four policy documents extracted from the official websites of the National Health Commission of the PRC and its three subordinate institutions(Department of Primary Health,the former Bureau of Medical Administration and the former Bureau of Disease Prevention and Control)were finally enrolled.They were mainly formulated by the Joint Prevention and Control Mechanism of the State Council in Response to the COVID-19,General Office and Department of Primary Health of the National Health Commission of the PRC.According to these policy documents,the major responsibilities of primary care institutions in containing COVID-19 include:early detection and reporting the suspected COVID-19 cases;receiving trainings regarding knowledge related to COVID-19 containment and emergency preparedness drills for coping with the pandemic;strengthening nosocomial COVID-19 infection containment and personal protection against the pandemic;cooperating with the community in fighting the COVID-19 pandemic;implementing health education about COVID-19 containmentusing a scientific approach;health management of priority populations;collecting and submitting nucleic acid samples;COVID vaccination.Conclusion Primary care institutions play a vital role in containing COVID-19 in China.The local governments should follow policy guidelines,and take measures according to the local conditions to facilitate the primary care in stitutions to better their performance in response to COVID-19 as frontline responders.