Study on The Basic Public Health Service in Shanghai

It is increasingly found that medical investment is not the only effective means to improve the national health level. The basic public health service, which is dominated by disease control and prevention, is paid more and more attention.This paper analyzes the relationship between the migrant population and the population of the city＇s household registration to the basic public health service. Access to basic public health services and satisfaction of the system, analysis of the factors affecting the satisfaction of the basic public health services in Shanghai revealed the problems and causes of development. Finally, putting forward the concrete countermeasures and suggestions for perfecting and improving the basic public health service in Shanghai.

Zibo MATO village public health service development present situation and problem analysis

Rural public health services in the relationship of farmers＇ quality of life and health, and the farmers＇ interests is closely related to the public, is very important to build a new socialist countryside. In national attention and support of the rural public health services in the development of big situation, based on the zibo MATO village as an example, the public health service development present situation has carried on the brief analysis, and describes the Jane MATO village problems of public health service.

Spatial Identities of Public Health Service Facilities in Metropolitan Suburban Communities: A Case Study of Shanghai Jinshan District

Both "Healthy China" and "Healthy Shanghai" programs require construction and development of community public health services. Taking Jinshan District in Shanghai as a case study, this paper evaluates the status quo of community health services from the "demand-supply" perspective, and finds a remarkable difference in the needs among different age groups, a big gap between urban and rural areas in the coverage degree of facilities, and different challenges for public service at the "prevention – treatment – health care" stages. It further puts forward several planning strategies involving(1) specific service supply based on different age groups,(2) "15-minute health service cycles" in both urban and rural communities,(3) adjustment of facilities to local conditions, and(4) promoting the quality of health services. Furthermore, it discusses in-depth issues underlying planning policies, such as the innovation of service content, the integration of different plans, and the cultivation of health service needs.

The Limits of the Intervention of Public Power in Individual Health Choices——From the Perspective of the Realization of the Right to Health in the Prevention and Control of Chronic Diseases

Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.

我国省域公共卫生服务与经济耦合协调及提升路径

目的探究我国各省域公共卫生服务与经济协调发展的现状及其影响因素,为地区实现高效、均衡发展提供建议。方法运用熵权法、耦合协调度、模糊集定性比较分析等方法评价我国各省域公共卫生服务与经济发展协调关系,借助fsQCA 3.0软件探究二者协调关系的影响因素与驱动路径。结果2020年我国各省域公共卫生服务与经济发展耦合协调度属于良好协调等级以上的地区较少,大部分地区处于濒临失调状态。条件变量的必要性检验一致性均≤0.9,单一条件变量对地方公共卫生服务与经济协调发展驱动能力有限,存在多条件变量构成复杂驱动路径。组态分析共得出8种组态结果,共归纳为3种组态路径,其中组态1与组态2属于地方高经济水平主导型驱动路径,组态3、组态4、组态5和组态8属于公共卫生服务与地方经济融合型驱动路径,组态6与组态7属于公共卫生服务主导型驱动路径。结论我国公共卫生服务与经济发展协调性整体不高,每万人口公共卫生机构数、每万人口公共卫生技术人员数以及人均国内生产总值等是影响地方公共卫生服务与经济协调发展的核心因素,不同条件变量组合可促进地方公共卫生服务与经济协调发展。低协调地区可根据本地区实际情况,参考高协调路径,实现公共卫生服务与经济协调发展。

基本公共卫生服务效率及其影响因素

目的基于2017年武汉市13个地区基层医疗卫生机构的横断面数据,分析武汉市基本公共卫生服务效率及其主要影响因素。方法采用松弛测度(slack-based-measure,SBM)-超效率数据包络分析(data envelopment analysis,DEA)模型,对武汉市基本公共卫生服务效率进行测算,通过Tobit回归分析进一步探讨其影响因素。结果2017年武汉市13个地区基本公共卫生服务的超效率、纯技术效率、规模效率几何均数分别为1.073、1.213、0.884。其中76.9%的地区为DEA有效,若非DEA有效地区能达到DEA有效,全市可少开办11家基层医疗卫生机构、减少1451张病床、节省6983万元基本公共卫生服务补助经费。60岁及以上老年人比例、平均期望寿命、每千人口卫生技术人员数、每千人口床位数对武汉市基本公共卫生服务效率的影响具有统计学意义。结论武汉市基本公共卫生服务效率地区差异较大,规模效率是制约基本公共卫生服务效率的关键因素。60岁及以上老年人比例越高、平均期望寿命越长、每千人口卫生技术人员数越多,基本公共卫生服务效率越低;每千人口床位数越多,基本公共服务效率越高。针对这些因素,需提高老年人健康管理水平,优化机构人员配置,合理调整机构规模,重视基本公共卫生服务的公益性。

Primary health care in China:A decade of development after the 2009 health care reform

Over 40 years ago,primary health care(PHC)was defined in the Alma-Ata Declaration as a critical component of the health care system to address the basic health demand of the people.In China,the Government attaches great importance to health care at the primary level.After the launch of the historical Reform of the Medical and Health Care System in 2009,the PHC system in China has witnessed major progress and breakthroughs,especially in its steadily increased capacity,continuously improved accessibility,and betterment in equality.In this review,we summarized published literatures and official policies,synthesized data from the electronic registration information system of the National Health Commission,national statistical reports,and yearbooks in health care.The review is intended to describe the systematic development of PHC in China in the last decade.The main results include:the solid national policy foundation,increasing number of PHC institutions and workforce,better training of PHC professionals,major achievements in primary health indicators,government financial support to PHC institutions,improved PHC budgeting and insurance coverage,and the advancement of supporting technologies.Challenges and prospects are also discussed.

上海市公共卫生技术服务机构传染病防治检测技术服务能力现况调查

目的 了解上海市公共卫生技术服务机构传染病防治检测技术服务能力现状,为进一步提升传染病防治检测技术服务行业总体能级水平提出建议,为相关政策和措施制定提供科学依据。方法 2020年4—6月,对上海市开展公共卫生技术服务的社会机构和市区两级疾病预防控制机构开展问卷调查,收集2019年度开展传染病防治检测技术服务的业务量和市场供需,以及截至2020年6月在6大类40项传染病防治检测技术服务细分领域能力参数的储备情况。结果 被调查机构2019年全年共提供31 763次传染病防治领域检测技术服务。社会委托性质技术服务为主要需求方,出具社会委托性质报告占报告总数的78.3% (24 859份),社会机构为该领域检测技术服务的主要提供方,出具报告占报告总数的73.1%(23 207份)。截至2020年6月,能力储备率最高的是医疗机构环境卫生学监测项目(82.7%),最低的是消毒灭菌设备项目(11.5%)。疾病预防控制机构的传染病防治领域检测技术服务总体能力储备率(50.0%)高于社会机构(25.9%),在医疗器械及物品细菌学监测、消毒剂项目的能力储备率上疾病预防控制机构和社会机构存在差异(P<0.05)。环氧乙烷低温灭菌综合性能监测/化学监测能力参数尚为“零能力储备”。结论 上海市传染病防治领域检测技术服务市场已形成一定规模,检测技术服务能力储备已有一定基础,疾病预防控制机构总体能力储备高于社会机构。细分领域能力储备不均衡,部分能力欠缺有待提升。疾病预防控制机构和社会机构共同作为传染病防治领域检测技术服务提供方,发挥各自优势特点,依托质量控制中心平台,共同提升传染病防治领域检测技术服务能力水平,促进传染病防治领域检测技术服务行业发展。