“十二五”期间浙江省公共卫生事业发展水平评价
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摘要
目的评价浙江省"十二五"期间公共卫生事业发展水平,为推进公共卫生事业发展提出思路和对策。方法收集2010—2015年浙江省公共卫生事业年报和政府部门公布的数据,采用德尔菲法建立公共卫生发展评价指标体系,以2010年为基准值确定各项指标目标值和权重,评价浙江省和各设区市"十二五"期间公共卫生的发展水平、发展速度并比较各设区市"十二五"期间公共卫生发展差异。结果浙江省公共卫生事业综合发展评价指数从2010年的100提高到2015年的138.44,年均增速达6.72%。30项评价指标中有13项指标的年均增速在6.72%~26.18%之间,均高于"十一五"末全部指标的平均增速(6.72%),17项指标增速低于6.72%,其中1项指标(高血压和糖尿病规范化管理率)年均增速为负值。每万人公共卫生人数(5.23)、新涂阳肺结核病人治愈率(90.76%)、基层医疗机构年度门急诊人次比例(49.45%)等3项指标低于全国同期平均水平(6.39、92.49%、56.40%)。2015年全省11个设区市公共卫生事业综合发展评价指数嘉兴最高,为156.35,衢州最低,为128.65;公共卫生综合发展评价指数的变异系数为5.76%,比"十一五"末的14.75缩小了8.99个百分点。结论 "十二五"期间浙江省公共卫生事业综合发展水平逐年提高,公共卫生发展指数地区差异明显缩小,但每万人公共卫生人员数、新涂阳肺结核患者治愈率和基层医疗机构年度门急诊人次比例等指标有待提高。
Objective To evaluate the development level of public health in Zhejiang Province during China's 12 th Five-Year Plan period(from 2011 to 2015) for health policy making in the future. Methods Totally 30 indexes were first summarized into 4 components, including the residents' health level, the allocation of public health resource, the level of public health service and public health security. The evaluation index system was developed by Delphi method. The indicators of 2010 were selected as the baseline for comparison with those corresponding indicators from 2011 to 2015. Each index(the comprehensive development index,the developmental speed,as well as the indicator index) calculated during 12 th Five-Year Plan period was evaluated after the targeted indicators were weighed. Results Overall, at a provincial level of Zhejiang, the comprehensive development index was increased from 100 in 2010 to 138.44 in 2015, representing an annual average development speed of6.72%. The annual average development speed of 13 indexes,ranging from 6.72% to 26.18%,were higher than those in the China's 11 th Five-Year Plan period(6.72%);while the annual average development speed of another 17 indexes was lower,with 1 index below zero. However,the number of medical staff per 10000 population(5.23),the treatment success rate among new smear-positive cases(90.76%) and the number of annual outpatient visits in primary hospitals(49.45%) in Zhejiang Province were lower than those in China during the same period(6.39, 92.49%, 56.40%). At a prefectural level, the comprehensive development index fluctuated from 128.65 in Quzhou to 156.35 in Jiaxing and the developmental speed was from3.90% to 11.26%. These results indicated that the coefficient variant(CV) was 5.76 during China's 12 th Five-year Plan period, which had recorded the historically lowest level since 2010. Conclusion During the China's 12 th Five-year Plan period,the development of public health in Zhejiang Province was steadily enhanced. Public health variably developed across 11 prefectures with shrinking gaps. Nevertheless, the number of medical staff per 10 000 population, the treatment success rate among new smear-positive cases and the number of annual outpatient visits in primary hospitals should be improved.
Objective To evaluate the development level of public health in Zhejiang Province during China's 12 th Five-Year Plan period(from 2011 to 2015) for health policy making in the future. Methods Totally 30 indexes were first summarized into 4 components, including the residents' health level, the allocation of public health resource, the level of public health service and public health security. The evaluation index system was developed by Delphi method. The indicators of 2010 were selected as the baseline for comparison with those corresponding indicators from 2011 to 2015. Each index(the comprehensive development index,the developmental speed,as well as the indicator index) calculated during 12 th Five-Year Plan period was evaluated after the targeted indicators were weighed. Results Overall, at a provincial level of Zhejiang, the comprehensive development index was increased from 100 in 2010 to 138.44 in 2015, representing an annual average development speed of6.72%. The annual average development speed of 13 indexes,ranging from 6.72% to 26.18%,were higher than those in the China's 11 th Five-Year Plan period(6.72%);while the annual average development speed of another 17 indexes was lower,with 1 index below zero. However,the number of medical staff per 10000 population(5.23),the treatment success rate among new smear-positive cases(90.76%) and the number of annual outpatient visits in primary hospitals(49.45%) in Zhejiang Province were lower than those in China during the same period(6.39, 92.49%, 56.40%). At a prefectural level, the comprehensive development index fluctuated from 128.65 in Quzhou to 156.35 in Jiaxing and the developmental speed was from3.90% to 11.26%. These results indicated that the coefficient variant(CV) was 5.76 during China's 12 th Five-year Plan period, which had recorded the historically lowest level since 2010. Conclusion During the China's 12 th Five-year Plan period,the development of public health in Zhejiang Province was steadily enhanced. Public health variably developed across 11 prefectures with shrinking gaps. Nevertheless, the number of medical staff per 10 000 population, the treatment success rate among new smear-positive cases and the number of annual outpatient visits in primary hospitals should be improved.
引文
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[2]张俊婕,赵琦,赵根明.绩效评价在公共卫生体系建设中的应用[J].中华流行病学杂志,2009,30(8):865-866.
[3]崔霞.中国公共卫生服务体系绩效评价[J].中国公共卫生,2011,27(12):1612-1613.
[4]陈其伟,孟雪晖,冯启明,等.县级疾病预防控制中心突发公共卫生事件应对能力的评价指标体系构建研究[J].应用预防医学,2015,21(5):296-299.
[5]于勇,陶立坚,杨土保.基本公共卫生服务均等化评价指标体系的构建[J].中南大学学报(医学版),2014,39(5):511-516.
[6]赵艳荣,杨清,韩宗梅,等.区域基本公共卫生服务评价方法研究[J].浙江预防医学,2014,26(2):133-136,145.
[7]韩春雷,陈利.我国公共卫生服务均等化评价指标体系及证实研究[J].中国卫生事业管理,2013,299:324-326,399.
[8]孙晓霞,陶箐,金新政.中国公共卫生服务绩效评价研究[J].中国卫生质量管理,2013,20(3):13-17.
[9]赵根明,赵琦,张俊婕,等.农村公共卫生服务体系绩效评价指标在农村卫生改革中的实践[J].中国卫生政策研究,2015,8(11):15-20.
[10]张利平,李望晨.突发公共卫生危机应急能力评价统计建模对策研究[J].中国卫生统计,2015,32(1):168-170.
[11]赵志广,侯万里,许舒乐,等.中国公共卫生绩效考核研究系统评价[J].中国全科医学,2014,17(19:):2184-2188.
[12]汪炜,叶驰宇,徐校平,等.TOPSIS法在区域基本公共卫生服务项目评价中的应用[J].预防医学,2017,29(4):424-426.
[13]汪垂章,胡伟,许锋华,等.区域公共卫生事业发展水平评价研究[J].浙江预防医学,2015,27(7):649-652.
[14]徐桂春.关于绩效考核评价体系在基本公共卫生服务项目管理中的应用的探讨[J].世界最新医学信息杂志文摘,2015,15(80):151-152.
[15]宋俐,羊海涛.应用德尔菲法建立农村基本公共卫生服务评价指标体系[J].江苏预防医学,2011,22(2):10-13.
[16]孟雪晖,崔仕臣,陈其伟,等.广西县级医院突发公共卫生事件应对能力评价指标体系构建[J].中国医院,2015,19(11):27-29.
[17]何莎莎,陈曦,冯占春.基于三角模糊层次的基本公共卫生服务均等化效果评价研究[J].中国卫生经济,2012,31(7):43-46.
[18]王晓东,吴群红,郝艳华,等.突发公共卫生事件应急能力指标体系构建研究[J].中国卫生经济,2013,32(6):47-50.
[19]丛树海,李永友.中国公共卫生支出综合评价及政策研究[J].上海财经大学学报,2008,10(4):53-60.
[20]浙江省公共卫生工作委员会办公室.“十二五”浙江省公共卫生发展水平综合评价报告[R].2016:3-51.