新冠前后我国重大疫情应急处置目标设置状况变化

Changes in target setting for major epidemic emergency response in China before and after COVID-19 epidemic:an official documents analysis

目的分析新冠疫情前后我国重大疾病疫情应急处置的目标提升程度变化,总结优势与不足,为提高我国重大疾病疫情应急处置目标设置水平提供依据。方法系统收集中国内地31个省(自治区、直辖市,以下简称为“内地31省”)2000—2020年公开发布的与重大疫情防控相关的规划、法律法规、工作方案等政策文件共计3864份,摘录目标设置有关内容,计算重大疾病应急处置目标设置与公众需要相匹配的程度(每年新增目标在上一年基础上累计计算,重复目标不赋值参与计算),并用配对秩和检验对疫情发生前后的指标差异进行统计检验。结果新冠疫情发生前(累计至2019年)和新冠发生后(累计至2020年)我国重大疾病疫情应急处置的目标设置与公众需要匹配程度由79.7%提升至91.3%,提升幅度为14.6%,其中东部和西部地区分别由81.2%、78.3%提升至93%、90.1%,提升幅度分别为14.5%和15.1%,差异具有统计学意义(P<0.05)。一级预防目标与公众需要匹配程度全国水平由36.9%提升至46.4%,差异具有统计学意义(P<0.05),二级预防目标、三级预防目标与公众需要匹配程度各地区及全国水平在新冠前后差异均无统计学意义。结论我国重大疾病疫情应急处置目标设置与公众需要匹配程度进一步提升,区域间水平较均衡,一级预防目标与公众需要匹配程度提升水平显著。

Objective To analyze changes in target setting for emergency response to major disease epidemics in China before and after the coronavirus disease 2019(COVID-19)pandemic,summarize strengths and weaknesses in target setting,and provide a basis for improving target setting for emergency response to major disease epidemics in China.Methods We systematically retrieved a total of 3864 policy documents(including plans,laws and regulations,and work programs)related to the prevention and control of major epidemics issued by government agencies of 31 provincial-level administrative divisions(PLADs)in Chinese mainland from 2000 to 2020.Relevant target content was extracted and the degree of consistency between emergency response targets for major diseases and public demand was calculated(the newly added targets are calculated on a cumulative basis from the precious year,and no value is assigned for duplicates).Paired rank sum tests were used to statistically test for differences in indicators before and after the epidemic.Results The consistency between the overall goal of emergency response to major disease epidemics and public needs in China increased from 79.7%by 2019(before COVID-19)to 91.3%in by 2020(after COVID-19),with an increase of 14.6%,and the region-specific consistency increased from 81.2%to 93%for the eastern region and from 78.3%to 90.1%for the western region,with an increase of 14.5%and 15.1%,respectively,and a significant difference between the regions(P<0.05).National consistency between the primary prevention goal of emergency response to major disease epidemics and public needs increased from 36.9%to 46.4%,with a significant difference between the periods before and after the COVID-19 epidemic(P<0.05);there were no significant differences between periods in consistency between the secondary and tertiary prevention goals of emergency response to major disease epidemics and public needs at either the national or regional level.Conclusion Consistency between emergency response goals for major disease epidemics and public needs in China has increased,either at the national or regional level,especially for primary prevention goals.