中国省级区域高血压预防控制能力优势、短板与关键控制点分析  

Strengths,shortcomings and key control points of capacity-building in hypertension prevention and control:a comparative analysis among provincial-level administrative divisions in China

作　　者：王兰 俞沁雯 王鑫 施培武 沈群红[2,4] 陈政 蒲川[2,6] 徐凌忠 胡志[2,8] 马安宁 徐天强[2,10] 王磐石 汪华[2,12] 郝超 周庆誉[1,2] 郝模 李程跃[1,2] WANG Lan;YU Qinwen;WANG Xin;SHI Peiwu;SHEN Qunhong;CHEN Zheng;PU Chuan;XU Lingzhong;HU Zhi;MA Anning;XU Tianqiang;WANG Panshi;WANG Hua;HAO Chao;ZHOU Qingyu;HAO Mo;LI Chengyue(Research Institute of Health Development Strategies,Fudan University,Shanghai 200032,China;Collaborative Innovation Center of Social Risks Governance in Health,Fudan University,Shanghai 200032,China;Zhejiang Academy of Medical Sciences,Hangzhou 310012,China;School of Public Policy and Management,Tsinghua University,Beijing 100044,China;Department of Grassroots Public Health Management Group,Public Health Management Branch of Chinese Preventive Medicine Association,Shanghai 201800,China;School of Public Health and Management,Chongqing Medical University,Chongqing 400016,China;School of Public Health,Shandong University,Ji′nan 250012,China;Anhui Medical University,Hefei 230032,China;Jining Medical University,Jining 272067,China;Institute of Inspection and Supervision,Shanghai Municipal Health Commission,Shanghai 230031,China;Shanghai Municipal Health Commission,Shanghai 230031,China;Jiangsu Preventive Medicine Association,Nanjing 210009,China;Changzhou Center for Disease Control and Prevention,Changzhou 213003,China)

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [2]健康风险预警治理协同创新中心,上海200032 [3]浙江省医学科学院,杭州310012 [4]清华大学公共管理学院,北京100044 [5]中华预防医学会公共卫生管理分会基层公共卫生管理学组,上海201800 [6]重庆医科大学公共卫生与管理学院,重庆400016 [7]山东大学公共卫生学院,济南250012 [8]安徽医科大学,合肥230032 [9]济宁医学院,济宁272067 [10]上海卫生健康委员会监督所,上海200031 [11]上海市卫生健康委员会,上海200031 [12]江苏省预防医学会,南京210009 [13]常州市疾病预防控制中心,常州213003

出　　处：《中国公共卫生》2023年第9期1089-1095,共7页Chinese Journal of Public Health

基　　金：上海市加强公共卫生体系建设三年行动计划项目(GWIV-32,GWV-12);国家自然科学基金(71774031,72074048);上海人才发展资金资助项目(2020128)。

摘　　要：目的评价中国内陆31个省(自治区、直辖市)高血压预防控制能力,明确其优势、短板及关键控制点,为提升高血压预防控制能力提供参考依据。方法收集中国内陆31个省级1995年1月—2019年12月所有涉及高血压预防控制的政策文件、信息报告、研究文献等公开资料,依据适宜公共健康体系评价标准评估各省级区域高血压预防控制能力,采用规范差距分析法明确其优势与短板,并应用多元线性回归模型结合敏感性分析明确其关键控制点。结果中国31个省(自治区、直辖市)2019年高血压预防控制能力适宜程度平均为47.10%,2000—2019年高血压预防控制能力适宜程度年均增长率为18.75%,呈上升趋势(Z=6.067,P<0.001);高血压预防控制能力的优势为组织架构较为完备、中长期计划已全面覆盖、管理监控机制内容形式较为健全,短板为人财物等资源配置不足以及管理与协调、中长期目标和评价标准等各项管理机制的落实程度较低;人员有效激励程度、组织体系协调程度、激励机制覆盖范围、评价标准可落实程度和服务提供与需要匹配程度分别为资源配置、组织体系、管理机制建立、管理机制落实和服务提供指标群中的关键控制点,若达到适宜,可分别促进高血压预防控制能力的适宜程度提高23.14%、66.40%、15.77%、23.43%和7.06%。结论中国省级区域高血压预防控制能力水平持续提升,但亟需加强资源配置,解决各部门职责不清晰、管理机制落实不到位等问题,以促进能力水平的进一步提升。Objective To evaluate the capacity for hypertension prevention and control and to identify strengths,shortcomings and key control points of the capacity-building in 31 provincial-level administrative divisions(PLADs)in China.Methods Policy documents,information reports,and research literature on hypertension prevention and control in 31 PLADs of China published from January 1995 through December 2019 were systemically collected via searching relevant websites and statistical yearbooks for evaluating on hypertension prevention and control capacity across the 31 PLADs according to the standards for appropriate public health system.Normative gap analysis was used to explore strengths and shortcomings of the capacity-building and multiple linear regression and sensitivity analysis were used to clarify key control points of the capacity-building.Results The average index for the appropriateness of hypertension prevention and control capacity-building was 47.10%among 31 PLADs of China in 2019,and the average annual increasing rate of the capacity-building was 18.75%from 2000 to 2019,showing a significant upward trend(Z=6.067,P<0.001).The strengths of hypertension prevention and control capacity-building for the PLADs include more complete organizational structure established,comprehensive coverage of medium-and long-term plans,and sound management and monitoring mechanisms;while the shortcomings are insufficient allocation of human and financial resources and low implementation of multi-dimensional management mechanisms such as management and coordination,medium-and long-term goals and evaluation criteria.The identified key control points for the five aspects in hypertension prevention and control capacity-building are effective motivation of personnel for resource allocation,the coordination for organizational framework,the coverage of incentive measures for management mechanism,practicable assessment criteria for management process evaluation,and the balance between supply and demand of medical service for service of

关 键 词：高血压 预防控制 能力 优势 短板 关键控制点 省级区域 中国 

分 类 号：R544.1[医药卫生—心血管疾病]