国家基本公共卫生服务实施十年的进展与成效
【目的】梳理总结全国国家基本公共卫生服务项目在过去十年（2009-2019年）所取得进展与成效。【方法】通过函调收集31个省（自治区、直辖市）基本公共卫生项目各项监测数据(2009-2016)，分析国家基本公共卫生服务管理平台监测数据(2017-2019)，以及中国卫生健康统计年鉴（2010-2020）相关指标，从供方角度分析了十年间全国基本公共卫生各项服务的提供覆盖情况；在2019年11月-12月，在山西省、浙江省、重庆市开展了国家基本公共卫生服务十年评估居民调查，共调查10213人，从需方角度调查居民对基本公卫项目的知晓率、利用率、满意度等情况。【结果】十年间，我国基本公共卫生的各类服务项目的覆盖率均有较大幅度增长：（1）健康档案建档率、电子健康档案建档率、健康档案使用率分别从2009年的48.78%、35.07%、22.14%上升到至2019年的88.25%、86.82%、55.34%，平均年增长率分别为6.41%、10.92%、15.62%；（2）全国发放健康教育印刷资料累计约63.11亿份，播放健康教育音像资料次数约3.37亿次，举办健康教育讲座累计参加人数达11.44亿人；（3）截止到2019年，全国管理在册的高血压患者约1.09亿人，糖尿病患者约3135.71万人，高血压/糖尿病患者的规范管理率十年间分别增长30.35%、27.25%，高血压/糖尿病管理人群的血压/血糖控制率十年间分别增长16.84%、24.69%，平均年增长率分别为3.28%、5.56%，东中西部地区以上指标的差距呈逐渐缩小趋势；（4）新生儿访视率、0-6岁儿童健康管理率的十年增长幅度分别为14.09%、17.82%，平均年增长率1.74%、2.30%；孕产妇早孕建册率和产后访视率增长6.06%、7.79%；2019年，全国老年人健康管理率67.41%，较2009年增长26.23%，平均年增长率为5.96%；老年人和儿童的中医药健康管理服务的平均年增长率为13.20%、10.10%；（5）居民预防接种建证率和各类疫苗接种率均稳定在90%以上；严重精神障碍患者规范管理率2019年达89.17%，肺结核患者管理率及肺结核患者规则服药率10年来均稳定在90%以上，传染病疫情报告率稳定在98%以上；（6）2019年参与调查的居民对“国家基本公共卫生服务项目”的知晓率为85.4%，重点人群的服务满意度均在90%以上；（7）基层医疗卫生服务机构的服务能力有所提升，机构数量呈现持续上升趋势，基层医疗卫生机构人员数量、医护比、本科以上学历占比均逐年上升。【结论】十年来，作为我国基本医疗卫生服务的重要组成部分，基本公卫各服务项目人群覆盖率均有较大幅度增长，服务广覆盖的目标基本达成，重点人群健康管理水平提升显著，健康管理效果呈现，居民对基本公共卫生服务的获得感逐步提高，基层医疗卫生机构服务能力不断提升，我国基本公共卫生服务的全面实施是向“全民健康覆盖”目标迈进的重要举措。
Objective: to systematically sort out and summarize the progress and achievements of basic public health projects in the past decade (2009-2019).Methods: The monitoring data (2009-2016) of basic public health projects in 31 provinces (autonomous regions and municipalities directly under the central government) were collected by correspondence, the monitoring data of the national basic public health service management platform (2017-2019) and the relevant indicators of China's Health Statistical Yearbook (2010-2020) were analyzed, and the coverage of basic public health services in the country in the past ten years was analyzed from the perspective of suppliers; From November to December 2019, a national ten-year assessment survey of basic public health services was conducted in Shanxi Province, Zhejiang Province and Chongqing City, with a total of 10213 people surveyed. From the perspective of the demander, the awareness rate, utilization rate and satisfaction of residents with basic public health projects were investigated. Results: Over the past decade, the coverage of various service items of basic public health in China has increased significantly: (1) the filing rate of health files, the filing rate of electronic health files and the utilization rate of health files have increased from 48.78%, 35.07% and 22.14% in 2009 to 88.25%, 86.82% and 55.34% in 2019, with an average annual growth rate of 6.41%, 10.92% and 15.62% respectively; (2) A total of 6.311 billion printed materials on health education were distributed nationwide, about 337 million audio-visual materials on health education were broadcast, and a total of 1.144 billion people attended health education lectures; (3) By 2019, there will be about 109million registered hypertensive patients and about 31357100 patients with diabetes in China. The standardized management rate of hypertensive / diabetes patients has increased by 30.35% and 27.25% respectively in the past decade. The blood pressure/blood glucose control rate of hypertension/diabetes management group increased by 16.84% and 24.69%, respectively, with an average annual growth rate of 3.28% and 5.56%, respectively. The gap between the above indicators in the eastern, central and western regions is gradually narrowing; (4) The ten-year growth rates of neonatal visit rate and health management rate of children aged 0-6 years were 14.09% and 17.82% respectively, with an average annual growth rate of 1.74% and 2.30%; The rate of early pregnancy registration and postpartum visit increased by 6.06% and 7.79%; In 2019, the national elderly health management rate was 67.41%, an increase of 26.23% over 2009, with an average annual growth rate of 5.96%; The average annual growth rate of traditional Chinese medicine health management services for the elderly and children is 13.20% and 10.10%; (5) The vaccination certificate establishment rate and various vaccination rates of residents were stable at more than 90%; The standardized management rate of patients with severe mental disorders reached 89.17% in 2019, the management rate of patients with pulmonary tuberculosis and the regular medication rate of patients with pulmonary tuberculosis have been stable at more than 90% in the past 10 years, and the reporting rate of infectious diseases has been stable at more than 98%; (6) In 2019, the awareness rate of residents participating in the survey on the "national basic public health service project" was 85.4%, and the service satisfaction of key groups was more than 90%; (7) The service capacity of grass-roots medical and health service institutions has been improved, and the number of institutions has shown a continuous upward trend. The number of personnel in grass-roots medical and health institutions, the proportion of doctors and nurses and the proportion of Bachelor degree or above have increased year by year. Conclusion: Over the past decade, the population coverage of basic public health services has increased significantly, the goal of wide service coverage has been basically achieved, the health management level of key populations has been significantly improved, the effect of health management has been presented, the residents' sense of access to basic public health services has been gradually improved, and the service capacity of basic medical and health institutions has been continuously improved. The comprehensive implementation of basic public health services in China is an important step towards the goal of "universal health coverage".
尤莉莉, 赵金红, 陈新月, 杨凌鹤, 刘美岑, 潘钰婷, 张思琪, 刘远立
10.12114/j.issn.1007-9572.2022.0407
预防医学医药卫生理论医学现状、医学发展
国家基本公共卫生服务项目项目评价健康管理获得感
尤莉莉, 赵金红, 陈新月, 杨凌鹤, 刘美岑, 潘钰婷, 张思琪, 刘远立.国家基本公共卫生服务实施十年的进展与成效[EB/OL].(2022-07-09)[2025-08-02].https://chinaxiv.org/abs/202207.00078.点此复制
评论