国家慢性病综合防控示范区建设的效果评价

毛凡; 姜莹莹; 董文兰; 吉宁; 董建群

Abstract

毛凡,姜莹莹,董文兰,吉宁,董建群.国家慢性病综合防控示范区建设的效果评价[J].Chinese journal of Epidemiology,2017,38(4):496-502

国家慢性病综合防控示范区建设的效果评价

On National Demonstration Areas: a cluster analysis

Received:September 02, 2016

DOI：10.3760/cma.j.issn.0254-6450.2017.04.017

KeyWord: 国家慢性病综合防控示范区系统聚类慢性病防控评价

English Key Word: National Demonstration Area for comprehensive prevention and control of non-communicable disease System clustering Chronic disease control and prevention Evaluation

FundProject:

Author Name	Affiliation	E-mail
Mao Fan	Department of Chronic Disease Prevention and Evaluation, Department of Risk Factor Intervention and Health Promotion, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Jiang Yingying	Department of Chronic Disease Prevention and Evaluation, Department of Risk Factor Intervention and Health Promotion, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Dong Wenlan	Department of Chronic Disease Prevention and Evaluation, Department of Risk Factor Intervention and Health Promotion, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Ji Ning	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Dong Jianqun	Department of Chronic Disease Prevention and Evaluation, Department of Risk Factor Intervention and Health Promotion, Chinese Center for Disease Control and Prevention, Beijing 100050, China	workdong@163.com

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Abstract:

目的了解国家慢性病综合防控示范区建设工作相对薄弱的省份及当前示范区慢性病防控工作中的薄弱环节，为下一步加强示范区建设工作，促进不同省份之间的工作交流提供科学依据。方法采用系统聚类的方法，对各省（自治区、直辖市）国家慢性病综合防控示范区建设效果（覆盖率和评价指标得分）以及慢性病防控工作得分情况进行聚类分析。结果全国29个省份和新疆生产建设兵团（西藏和青海除外）按照示范区建设效果大致可归为6类：上海；北京、浙江、重庆；天津、山东、广东和新疆生产建设兵团；河北、福建、湖北、江苏、辽宁、新疆、湖南和广西；山西、吉林、河南、海南、四川、安徽和江西；内蒙古、陕西、宁夏、贵州、云南、甘肃和黑龙江。示范区24项慢性病防控工作按照得分情况大致可归为4类：队伍保障、宣传日活动、宣传资料技术支持、政策保障、经费保障、媒体宣传、社区宣传和支持性环境、群众社区健身活动、儿童青少年健康促进、组织保障和患者自我管理；平衡膳食、慢性病及危险因素监测、烟草控制和社区诊断；高危人群干预、高危人群发现、心脑血管事件报告、基本公共卫生服务均等化、工作场所干预、示范创建和死因监测；口腔卫生和肿瘤登记。其中，口腔卫生、肿瘤登记以及高危人群干预、高危人群发现、心脑血管事件报告、基本公共卫生服务均等化、工作场所干预、示范创建、死因监测等工作是当前示范区慢性病防控工作的薄弱环节。结论西部地区示范区建设仍相对落后。示范区肿瘤登记、心脑血管事件报告、死因监测等慢性病监测工作以及高危人群发现及干预等慢性病综合防控工作相对薄弱，复审环节应加大对这些结果指标的重点考核。

English Abstract:

Objective To understand the ‘backward’ provinces and the relatively poor work among the construction of National Demonstration Area, so as to promote communication and future visions among different regions. Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces, including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system. Results According to the results from the construction of National Demonstration Area, all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories: Shanghai; Beijing,Zhejiang, Chongqing; Tianjin, Shandong, Guangdong and Xinjiang Production and Construction Corps; Hebei, Fujian, Hubei, Jiangsu, Liaoning, Xinjiang, Hunan and Guangxi; Shanxi, Jilin, Henan, Hainan,Sichuan, Anhui and Jiangxi; Inner Mongolia, Shaanxi, Ningxia, Guizhou, Yunnan, Gansu and Heilongjiang. Based on the scores gathered from this study, 24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories: Manpower, special day on NCD, information materials development, policy/strategy support, financial support, mass media, enabled environment, community fitness campaign, health promotion for children and teenage, institutional structure and patient self-management; healthy diet, risk factors on NCDs surveillance, tobacco control and community diagnosis; intervention of high-risk groups, identification of high-risk groups, reporting system on cardiovascular and cerebrovascular events, popularization of basic public health service, workplace intervention programs, construction of demonstration units and mortality surveillance; oral hygiene and tumor registration. Contents including oral hygiene, tumor registration, intervention on high-risk groups, identification of high-risk population, reporting system on cardiovascular and cerebrovascular events, popularization of basic public health service, workplace intervention programs, construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area. Conclusions Western regions, especially in some remote provinces had the poorest performance during the construction of National Demonstration Area. Programs regarding chronic disease surveillance, identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on, during the next term of review, in these areas.

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