上海某区社区卫生服务中心公共卫生应急能力现况研究

Current status of public health emergency response capabilities of community health service centers in a certain district of Shanghai

目的针对社区卫生服务中心应急管理中的应急指挥与沟通、预案建设、预警监测、应急处置、演习演练和应急培训等维度开展调研和分析,以期梳理和展示上海市某区基层卫生应急能力区域特征。方法本研究选取了上海市某区辖区内全部13家社区卫生服务中心,采用自设计访谈提纲《公共卫生应急能力评价访谈提纲(社区卫生服务中心版)》开展访谈和调研,包含应急体制设置、应急指挥与管理、预案管理、能力建设、健康宣教、实践工作等部分共计23个问题,涉及对象主要为社区卫生服务中心管理者,并在调研过程中针对关键问题开展访谈。结果在资源储备方面,研究对象所设立应急队伍实有成员数量充足(平均82人)主要为急救医护、应急值班和现场流调采样人员,资金上实际投入应急工作经费差异较大(3.7万~100.8万,平均20.9万),应急物资储备总价值平均3.6万元,并且普遍在2020年得到了增长。在应急管理方面,13家社区卫生服务中心均建立应急领导小组、值班制度并编制了本单位卫生应急预案和突发公共卫生事件医疗救治方案,对聚集性疫情信息开展了监测,6家中心建立有突发公共卫生事件风险评估工作制度和机制。在培训演练方面,研究对象全部每年参加1次以上的演练和培训。结论当前社区卫生服务中心公共卫生应急管理人力资源储备难以满足突发疫情时期骤增需求。物资和资金保障是基层开展应急响应的基础,要充分发挥社区卫生服务中心公共卫生应急职能,优化应急沟通与协同机制,加强应急培训与演练,提升社区卫生服务中心应急能力。

Objective To survey,research and analyze the dimensions like emergency command,communication,plan building,early warning monitoring,emergency disposal,drill and emergency response training in the emergency management of community health service centers so as to sort out and display the characteristics of primary health emergency response capacities in a certain district of Shanghai Municipality.Methods All 13 community health service centers in a certain district of Shanghai Municipality were selected in this study.We conducted an interview and survey by using a self-designed interview outline questionnaire,Public Health Emergency Capability Evaluation Questionnaire(Community Health Service Center Version),and the contents included 23 questions like emergency system setup,emergency command and management,plan management,capacity building,health publicity and education and practical work.Most subjects involved were managers of community health service centers,and interviews on key issues were performed during the survey.Results In terms of reserve supply of medical resource,there were sufficient actual members(82 on average)in the emergency response teams,and most of them were emergency medical service professionals,emergency response staff on duty and on-site epidemiological investigation and sampling personnel.The funds actually invested in the work regarding emergency response varied greatly(37,000-1,008,000 yuan,with an average of 209,000 yuan).The average of total value of emergency supplies was 36,000 yuan,and it generally increased in 2020.As for emergency management,all 13 community health service centers built emergency leader groups and on-duty systems,and set up their own centers’health emergency response plans and medical treatment plans for public health emergency,and monitored the information on clustering epidemics.6 community health service centers established working systems and mechanisms for risk assessment of public health emergencies.In terms of training drills,all the research subjects participated in more than one drill and training session per year.Conclusion Currently,human resource reserve for public health emergency management in the community health service centers cannot meet the needs of sudden increase emergencies during the epidemic.Material and financial supply and reserve are the foundation of response to health emergencies in primary care settings.It is necessary to give full play to the public health emergency function of community health service centers,optimize emergency communication and coordination mechanisms,and strengthen emergency response training and drills so as to improve emergency response capacities of the community health service centers.