2017—2022年深圳市基本公共卫生服务实施进展与趋势
Progress and Trends in the Implementation of Essential Public Health Services in Shenzhen，2017-2022
背景 ?自2009年启动国家基本公共卫生服务项目以来，全国各地普遍开展各项服务，由于各省市经济发展水平不同，其基本公共卫生服务项目的实施情况和进展也不同。深圳市作为全国性经济中心城市和国家创新性城市，信息化技术位于全国城市前列。目的 ?梳理并总结深圳市2017—2022年基本公共卫生服务的实施进展与趋势，为进一步推进深圳市基本公共卫生服务高质量发展提供参考。方法 ?于2022年7月—2023年4月，收集2017—2022年深圳市项目投入、项目执行和项目效果3个维度共计54项的基本公共卫生服务评价指标，分析各指标在2017—2022年六年间的变化趋势。结果 ?（1）深圳市基本公共卫生服务项目实际到位经费从2017年的80.71元增加到2022年的144.86元，社康工作人员总数由9992人增长到13758人，公卫医师占基层医务人员比例从5.39%提高到5.94%。（2）电子健康档案建档率、新生儿访视率、0~6岁儿童健康管理率、早孕建册率、产后访视率、孕产妇系统管理率、老年人健康管理率、严重精神障碍患者规范管理率、肺结核患者规范服药率、老年人中医药健康管理率、0~36个月儿童中医药健康管理服务率的平均年增长率分别为6.27%、0.32%、2.61%、1.06%、0.07%、0.62%、8.34%、2.11%、0.51%、9.53%、5.01%，而健康档案使用率、高血压患者规范管理率、糖尿病患者规范管理率从2017年的77.40%、72.48%、72.09%减少至2022年的36.58%、64.14%、66.32%。（3）居民健康素养具备率、参加体育锻炼人数比例、6个月内婴儿纯母乳喂养率的平均年增长率分别为23.75%、15.86%、5.35%，且新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率的平均年增长率分别为-1.71%、-4.25%、-1.63%；管理人群血压控制率、管理人群血糖控制率从2017年的70.84%、67.41%下降至2022年的69.33%、60.82%，剖宫产率、出生缺陷发生率、低出生体重率、5岁以下儿童低体重率、5岁以下儿童贫血患病率、5岁以下儿童肥胖率的平均年增长率分别为0.74%、1.87%、3.97%、3.85%、11.03%、33.50%。2018—2022年群众知晓率从86.26%下降至68.77%，居民满意度从88.51%增加至91.00%。结论 ?深圳市2017—2022年基本公共卫生服务取得显著成效，组织管理和财政支出不断加强，主体责任得到落实，人力资源队伍不断壮大；各类人群覆盖面广，健康教育效果初显，然而档案利用有待加强，需要进一步推进“老高糖”项目管理高质量发展，不断提高居民的知晓率和获得感。
Background ?Since the National Essential Public Health Service Program was launched in 2009various services have been commonly carried out across the countryand the implementation and progress of the program varies among provinces and cities due to their different levels of economic development. As a national economic center city and a national innovative cityShenzhen is at the forefront of informatization technology in cities across the country. Objective ?To sort out and summarise the implementation progress and trend of essential public health services in Shenzhen from 20172022and provide reference for further promoting the high-quality development of essential public health services in Shenzhen. Methods ?From July 2022 to April 2023Collect 54 evaluation indicators of essential public health services in Shenzhen from 2017 to 2022and analyse the trend of each indicator during the six-year periodResults ?1The actual funding in place for the National Essential Public Health Service Program in Shenzhen has increased from 80.71 yuan in 2017 to 144.86 yuan in 2022the total number of primary health workers has increased from 9 992 to 13 758and the proportion of public health physician in the primary medical staff increased from 5.39% to 5.94%.2The average annual growth rates of the electronic health record filing ratethe newborn visit ratethe health management rate for children aged 0-6 yearsthe early pregnancy filing ratethe postnatal visit ratematernal system management ratethe health management rate for the elderlythe standardised management rate for patients with severe mental disordersthe standardised medication rate for TB patientsand the rate of TCM health management services for the elderly and children aged 0-36 monthswere respectively 6.27%0.32%2.61%1.06%0.07%0.62%8.34%2.11%0.51%9.53%and 5.01%while the rates of health record utilisationstandardised management of hypertensive patientsand standardised management of diabetic patients decreased from 77.40%72.48%and 72.09% in 2017 to 36.58%64.14%and 66.32% in 2022.3The average annual growth rates of health literacy ratethe proportion of people participating in physical exerciseand the rate of exclusive breastfeeding of infants within six months are 23.75%15.86%and 5.35%and the average annual growth rates of the neonatal mortality ratethe infant mortality rateand the mortality rate of children under five years of age are -1.71%-4.25%and -1.63%. Respectivelythe blood pressure control rate of the managed population and the blood glucose control rate of the managed population decreased from 70.84% and 67.41% in 2017 to 69.33% and 60.82% in 2022and the average annual growth rates of the cesarean section ratethe incidence of birth defectsthe low birth weight ratethe low weight rate of children under the age of 5the prevalence of anaemia in children under the age of 5and the obesity rate of children under five-years old were 0.74%1.87%3.97%3.85%11.03%and 33.50%.The rate of public knowledge decreased from 86.26% to 68.77%and the rate of resident satisfaction increased from 88.51% to 91.00% from 2018 to 2022. Conclusion ?Shenzhen's essential public health services from 2017 to 2022 have achieved remarkable resultsorganization and management and financial expenditure have been strengthenedand the human resources continues to grow strongerall types of populations have wide coverageand the effect of health education has begun to show. Howeverthe use of health records needs to be strengthenedand there is a need to further promote the "the elderlythe high pressureand the diabetes" program management quality developmentand constantly improve the knowledge rate and sense of access of the residents.
李梦宇、刘璐、尤莉莉、刘刚、张思琪、王竞波、陈雪晖、王奕婧
预防医学医学现状、医学发展
公共卫生监测国家基本公共卫生服务项目绩效评估评价研究深圳
李梦宇,刘璐,尤莉莉,刘刚,张思琪,王竞波,陈雪晖,王奕婧.2017—2022年深圳市基本公共卫生服务实施进展与趋势[EB/OL].(2025-02-26)[2025-08-02].https://chinaxiv.org/abs/202502.00196.点此复制
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