新冠疫情前后中国内地重大疫情防控服务能力变化分析

Change in service capacity against major epidemics before and after COVID-19 epidemic in the Chinese Mainland:a policy document-based analysis

目的分析新冠疫情前后中国内地重大疫情防控服务能力的变化情况,为促进防控服务能力提升提供参考借鉴。方法系统检索中国内地31省(自治区、直辖市)政府部门和专业公共卫生机构等官方网站,结合北大法宝网补充,纳入2002-2020年重大疫情防控相关文件1756篇,摘录服务提供有关字段,计算服务覆盖和可考核程度以及防控服务能力,采用配对秩和检验分析东、中、西部等地区新冠前后服务能力的变化情况。结果中国内地2019年重大疫情防控服务覆盖程度已达到100%,事前、事中和事后服务可考核程度在新冠疫情前后分别由50.54%、61.29%、37.10%提升至65.59%、72.04%和38.71%,提升幅度分别为29.78%、17.54%和4.34%。东部地区事前以及西部地区事中的服务能力在新冠疫情前后分别由78.79%、65.00%提升至89.39%、76.67%(P<0.05),事后阶段的服务能力提升不明显。重大疫情防控服务能力在新冠疫情前后由66.00%提升至73.78%(P<0.001)。结论中国内地重大疫情防控服务能力在新冠疫情前后有所提升,但中部和西部地区仍需持续加强,其中事后评估是服务能力持续提升的重点。

Objective To analyze the change in service capacity against major epidemics before and after coronavirus disease 2019(COVID-19)in China for the promotion of the capacity.Methods Via systematic search on the official websites and the law documents website of Peking University(PKULAW),we collected totally 1756 policy documents relevant to major epidemic prevention and control issued during 2002-2020 by government departments and professional public health institutions in 31 provincial-level administrative divisions of China.Contents about the coverage and assessability of service capacity of major epidemic prevention and control were extracted from the documents and indexes for evaluating national and regional coverage and assessability were calculated based on the extracted contents.Paired signed-rank test was used to analyze changes in the indexes before and during COVID-19 epidemic.Results The coverage of major epidemic prevention and control services has reached 100%in the Chinese mainland in 2019.In comparison to those in 2019 before the emergence of COVID-19 epidemic,the national assessability indexes(%)for service capability of major epidemic prevention and control of pre-,ongoing-and post-stage increased in 2020 by 29.78%(65.59%vs.50.54%),17.54%(72.04%vs.61.29%)and 4.34%(38.71%vs.37.10%).the assessment index for service capability of major epidemic prevention and control of pre-stage increased from 78.79%to 89.39%for eastern region and that of ongoing-stage increased from 65.00%to 76.67%for western region(both P<0.05);but there was no significant increase in regional assessment index for service capability of major epidemic prevention and control of post-stage.The national assessment index for service capacity of major epidemic prevention and control of whole process increased significantly from 66.00%in 2019 to 73.78%in 2020 after the emergence of COVID-19 epidemic(P<0.001).Conclusion The overall service capacity of major epidemic prevention and control has improved after the emergence of COVID-19 epidemic in the Chinese Mainland but the service capacity needs to be improved in central and western regions;in addition,the post-event assessment on the service capacity should be concerned for the promotion of the service capacity.