Study on reporting and handling capacity of primary doctors on infectious dieases and public health emergencies
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摘要:
目的 了解中国基层医生传染病及突发公共卫生事件报告处置能力现状,并探讨提升基层医生能力策略。 方法 采用多阶段抽样和典型抽样,选取东部地区(江苏省)、中部地区(安徽省、河南省)、西部地区(重庆市、甘肃省)的基层医生进行问卷调查。 结果 在纳入分析的8 374位基层医生中,6 906位(82.5%)基层医生具备传染病及突发公共卫生事件报告处置能力,分别有7 261位(86.7%)、7 633位(91.2%)、7 867位(93.9%)基层医生具备风险管理能力、发现与报告管理能力、协助处置与管理能力;工作越接近基层的医生,工作实践经验越丰富,能力水平越高。 结论 中国基层医生传染病及突发公共卫生事件报告处置能力总体较好,但风险管理能力有待提升,需加强培训演练,积累工作经验,实现传染病及突发公共卫生事件的有效应对。 Abstract:Objective To understand the current situation of the abilty of primary doctors in China to report and handle infectious diseases and public health emergencies, and to explore strategies to improve their capacity. Methods Multi-stage sampling and typical sampling were used to select primary doctors from eastern (Jiangsu Province), central (Anhui Province, Henan Province) and western (Chongqing City, Gansu Province) region. And a questionnaire survey was conducted. Results Among 8 374 primary doctors included in the analysis, 6 906 (82.5%) had the ability to report infectious diseases and public health emergencies. Of 7 261 (86.7%), 7 633 (91.2%) and 7 867 (93.9%) of the primary doctors were competent in risk management, discovery and report management, and assistance with treatment and management, respectively. The doctors who work closer to the grassroots have more work experience and higher level of competence. Conclusions The ability of reporting infectious diseases and public health emergencies of primary doctors in China is generally good, but the ability of risk management needs to be improved. It is necessary to strengthen training and accumulate work experience to achieve effective response to infectious diseases and public health emergencies. -
Key words:
- Primary doctors /
- Infectious diseases /
- Public health emergencies /
- Practice drills
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表 1 传染病及突发公共卫生事件报告处置能力具备情况判断标准
Table 1. Judgment criteria for the ability to report and handle infectious diseases and public health emergencies
工作能力指标 能力评价具体内容 单方面能力判断 判断标准 1.风险管理 ①掌握传染病和突发公共卫生事件的预防原则和方法、传播途径、检测方法。②协助开展传染病疫情和突发公共事件风险排查,并收集和提供风险信息 2项均具备 当3方面工作能力指标均具备时,为基本具备传染病及突发公共卫生事件报告处置能力 2.发现、登记及报告 掌握报告程序和处理原则,并能够规范填写报告信息、准确上报 ― 3.协助处置和管理 协助开展传染病患者的急救、转诊、管理和宣传教育等工作 ― 表 2 基层医生的基本情况[n(%)]
Table 2. Basic characteristics of primary doctors [n(%)]
基本特征 东部 中部 西部 合计 调查人数 2 912(34.8) 3 161(37.7) 2 301(27.5) 8 374(100.0) 所在机构 社区卫生服务中心 1 021(35.1) 649(20.5) 332(14.4) 2 002(23.9) 社区卫生服务站 348(12.0) 99(3.1) 24(1.0) 471(5.6) 乡镇卫生院 684(23.5) 450(14.2) 851(37.0) 1 985(23.7) 村卫生室 859(29.5) 1 963(62.1) 1 094(47.5) 3 916(46.8) 年龄组(岁) <30 294(10.1) 185(5.9) 259(11.3) 738(8.8) 30~<45 1 306(44.8) 1 396(44.2) 1 023(44.5) 3 725(44.5) 45~<60 1 210(41.6) 1 431(45.3) 937(40.7) 3 578(42.7) ≥60 102(3.5) 149(4.7) 82(3.6) 333(4.0) 学历 高中及以下 867(29.8) 1 625(51.4) 756(32.9) 3 248(38.8) 大专 619(21.3) 908(28.7) 782(34.0) 2 309(27.6) 本科及以上 1 426(49.0) 628(19.9) 763(33.2) 2 817(33.6) 表 3 不同地区基层医生传染病及突发公共卫生事件报告处置能力具备情况[n(%)]
Table 3. Capacity of primary doctors to report infectious diseases and public health emergencies in different regions [n(%)]
地区 风险管理 发现、登记及报告 协助处置与管理 3项均具备 东部 2 503(86.0) 2 591(89.0) 2 710(93.1) 2 353(80.8) 中部 2 828(89.5) 2 950(93.3) 3 021(95.6) 2 725(86.2) 西部 1 930(83.9) 2 092(90.9) 2 136(92.8) 1 828(79.4) 合计 7 261(86.7) 7 633(91.2) 7 867(93.9) 6 906(82.5) χ2值 38.294 35.746 23.711 50.702 P值 <0.001 <0.001 <0.001 <0.001 表 4 不同学历基层医生传染病及突发公共卫生事件报告处置能力具备情况[n(%)]
Table 4. Ability to report infectious diseases and public health emergencies among primary doctors with different educational backgrounds [n(%)]
学历 卫生服务中心 卫生服务站 卫生院 卫生室 χ2值 P值 高中及以下 76(76.8) 121(80.1) 143(77.3) 2 500(88.9) 40.195 <0.001 大专 369(76.7) 113(88.3) 553(77.9) 855(86.4) 33.187 <0.001 本科及以上 1 058(74.4) 154(80.2) 866(79.4) 98(86.7) 16.289 0.001 合计 1 503(75.1) 388(82.4) 1 562(78.7) 3 453(88.2) 183.560 <0.001 表 5 不同年龄基层医生传染病及突发公共卫生事件报告处置能力具备情况[n(%)]
Table 5. Ability to report infectious diseases and public health emergencies among primary doctors at different ages [n(%)]
年龄组(岁) 卫生服务中心 卫生服务站 卫生院 卫生室 <30 218(70.6) 36(80.0) 275(76.8) 25(96.2) 30~<45 903(74.4) 167(81.5) 806(77.4) 1 122(88.4) 45~<60 354(79.4) 156(83.9) 475(82.0) 2 075(87.7) ≥60 28(73.7) 29(82.9) 6(100.0) 231(90.9) χ2值 6.220 0.435 5.241 0.000 P值 0.013 0.510 0.022 0.990 -
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