2014年中国慢性非传染性疾病预防控制能力评估

司向; 翟屹; 朱晓磊; 马吉祥

Abstract

司向,翟屹,朱晓磊,马吉祥.2014年中国慢性非传染性疾病预防控制能力评估[J].Chinese journal of Epidemiology,2019,40(2):231-236

2014年中国慢性非传染性疾病预防控制能力评估

Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014

Received:September 11, 2018

DOI：10.3760/cma.j.issn.0254-6450.2019.02.020

KeyWord: 慢性非传染性疾病预防控制能力

English Key Word: Chronic non-communicable disease Prevention Control Capacity

FundProject:中国疾病预防控制中心应急反应机制运行（131031001000150001）

Author Name	Affiliation	E-mail
Si Xiang	Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhai Yi	China National Clinical Research Center for Neurological Diseases, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100070, China
Zhu Xiaolei	Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Ma Jixiang	Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China	majix@163.com

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Abstract:

目的了解我国慢性非传染性疾病（慢性病）预防控制能力现状。方法 2014年9月至2015年3月通过网络问卷调查全国省、地（市）和县（区）级3 395个CDC和3 000个基层医疗卫生机构，了解慢性病预防控制相关的政策能力、基础配置能力、培训指导能力、合作与参与能力、监测能力、干预与管理能力、评估能力和科研能力。结果（1）政策能力：23个（71.9%）省级、139个（40.6%）地市级和919个（31.2%）县（区）级政府或卫生行政部门有现行慢性病防控相关规划。（2）基础配置能力：25个（78.1%）省级、136个（39.8%）地市级和529个（18.0%）县（区）级CDC设置了专门承担慢性病防控工作的部门。各级CDC有9 787人从事慢性病防控工作，占CDC总在岗人员的5.0%。68.1%的CDC配置了慢性病防控工作经费。（3）培训指导能力：2 485个（74.9%）CDC举办过慢性病防控相关培训班。2 571个（87.3%）县（区）级CDC对基层医疗卫生机构开展过指导。（4）合作与参与能力：CDC与媒体开展合作的比例最高（42.0%）。（5）监测能力：各级CDC开展死因监测的比例为73.8%；开展各类慢性病及危险因素监测的比例均不到50.0%。基层医疗卫生机构开展新发脑卒中和急性心肌梗死病例报告的比例分别为32.4%和29.9%。（6）干预与管理能力：各级CDC开展高血压和糖尿病患者个体化干预的比例分别为69.1%和68.2%，开展其他各类慢性病及危险因素干预的比例均不到40.0%。超过90.0%的基层医疗卫生机构开展了高血压或糖尿病患者随访管理工作，但高血压和糖尿病患者管理率分别仅为17.4%和13.7%，规范管理率分别为83.7%和80.4%，控制率分别为59.2%和55.2%。（7）评估能力：32.4%的卫生行政部门或CDC对本辖区慢性病应对情况开展了定期评估。（8）科研能力：省级CDC科研能力明显高于地（市）和县（区）。结论与前两次调查结果相比，各级慢性病防控政策能力呈稳步提高趋势，但总体仍较为薄弱；县（区）级CDC慢性病防控能力与省和地（市）级仍有较大差距，亟待提高；开展慢性病管理工作的基层医疗卫生机构比例较高，但管理效果不佳，与2010年和2012年的调查结果一致。

English Abstract:

Objective To assess the capacity of prevention and control on chronic non-communicable diseases (NCDs) in China. Methods On-line questionnaire survey was adopted by 3 395 CDCs at provincial, municipal and county (district) levels and 3 000 primary health care units, and assess on capacity of policy, infrastructure, capacity of training and guidance, cooperation, surveillance, intervention and management, assessment and scientific research from September 2014 to March 2015. Results (1) Capacity of policy:23 (71.9%) provincial, 139 (40.6%) municipal and 919 (31.2%) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs. (2) Capacity of infrastructure:25 (78.1%) provincial, 136 (39.8%) municipal and 529 (18.0%) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs, with 9 787 staff members, accounting for 5.0% of the total CDC personnel, working on NCDs prevention and control programs. 68.1% of the CDCs had special funding set for NCDs prevention and control. (3) Capacity of training and guidance:2 485 CDCs (74.9%) held all kinds of training on prevention and control of NCDs. 2 571 (87.3%) CDCs at the county (district) level provided technical guidance for primary health care units. (4) Capacity of cooperation:42.0% of the CDCs had experiences collaborating with the mass media. (5) Capacity of surveillance:73.8% of the CDCs had set up programs for death registration while less than 50.0% of the CDCs had implemented surveillance programs on major NCDs and related risk factors. In terms of primary health care units, 32.4% of them had set up reporting system for newly developed stroke case and 29.9% of them having programs on myocardial infarction case reporting. (6) Capacity of intervention and management:69.1% and 68.2% of the CDCs conducted individualized intervention programs on hypertension and diabetes, while less than 40.0% CDCs conducting intervention programs on other NCDs and risk factors. More than 90.0% of the primary health care units carried out follow-up surveys on hypertension and diabetes. However, only 17.4% and 13.7% of the CDCs working on hypertension and diabetes patient management programs while 83.7% and 80.4%, of them following the standardized guidelines for management, with successful rates of control as 59.2% and 55.2%, respectively. (7) Capacity of assessment:32.4% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs. (8) Capacity of scientific research:the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs. Conclusions Compared with the results of previous two surveys, the capacity on policies set for the prevention and control programs improved continuously, at all level NCDs, but remained relatively weak, especially at both county (district) and primary health care units.

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