突发公共卫生事件多点暴发下医疗浪涌能力建设路径研究

Study on the Path to Medical Surge Capacity Building under Multi-Point Outbreak of Public Health Emergencies

目的:医疗浪涌能力指医疗系统在突发公共卫生事件中满足医疗救治需求处于峰值时的能力。本研究旨在提出突发公共卫生事件多点暴发时医疗浪涌能力的建设路径,为发挥医疗机构应急救治、有序诊疗的重要功能提供参考。方法:采用案例分析法,选取2022年末全国疫情防控措施优化这一时间点,以全国为经受医疗浪涌冲击的典型案例,对多点医疗浪涌的特点和应对措施进行复盘总结,提出在突发公共卫生事件多点暴发下医疗浪涌能力的建设路径。结果:突发公共卫生事件多点暴发下医疗浪涌的应对系统可以构建为一个一体两翼的飞机模型。机身部分为浪涌应对的功能系统,包括浪涌识别子系统、浪涌承受子系统及浪涌分流子系统;飞机两翼则为浪涌应对的结构系统,包括决策指挥子系统和资源保障子系统。结论:我国多点医疗浪涌的应对展示了战略协同、多元响应的组织特征和运作机理。建立跨机构、跨区域的“无缝”浪涌能力,利用智慧化手段提升浪涌识别能力,“平战结合”增强浪涌承受能力,动员多元主体协同响应是突发公共卫生事件多点暴发下医疗浪涌能力建设的有效路径。

Objective To put forward a path for building medical surge capacity in the event of multi-point outbreaks of public health emergencies,and provide a reference for the important functions of emergency treatment and orderly diagnosis and treatment in medical institutions.Methods Case study method was adopted.The time point at the end of 2022 when the national epidemic prevention and control measures were optimized was selected,and the whole nation was taken as a typical case of enduring the impact of medical surges,then the characteristics of multi-point medical surges and responses were reviewed and summarized.Results The response system of medical surge under multi-point outbreaks of public health emergencies can be constructed as an airplane model with two wings.The fuselage of the airplane is the functional system of surge response,including surge identification subsystem,surge withstand subsystem and surge diversion subsystem,and the two wings are the structural system,including the decision-making command subsystem and resource security subsystem.Conclusion The response to multi-point medical surges in China demonstrates the organizational char-acteristics and operational mechanism of strategic synergy and multiple responses.The effective paths to build medical surge capacity in the event of a multi-point outbreak of public health emergencies are establishing cross-institutional and cross-regional"seamless"surge capacity,using intelligent means to enhance surge identification capabilities,enhancing surge withstand capacity by"a combina-tion of peacetime and wartime",and mobilize multiple subjective coordinated response.