新冠疫情前后中国内地重大疫情防控激励机制覆盖范围变化分析  

Coverage of incentive and disciplinary measures established by government and professional departments for promoting containment of major epidemics in the Chinese Mainland before and after COVID-19 epidemic:a documents-based comparison analysis

作　　者：杨怡凡 施培武[2,15] 沈群红 张朝阳[4,15] 陈政 蒲川 徐凌忠[7,15] 胡志 马安宁[9,15] 龚朝晖 徐天强[11,15] 王磐石 汪华[13,15] 郝超 郝模[1,15] 周庆誉 李程跃 YANG Yifan;SHI Peiwu;SHEN Qunhong;ZHANG Chaoyang;CHEN Zheng;PU Chuan;XU Lingzhong;HU Zhi;MA Anning;GONG Zhaohui;XU Tianqiang;WANG Panshi;WANG Hua;HAO Chao;HAO Mo;ZHOU Qingyu;LI Chengyue(Research Institute of Health Development Strategies,Fudan University,Shanghai 200032,China;Zhejiang Academy of Medical Sciences,Hangzhou 310012,China;School of Public Policy and Management,Tsinghua University,Beijing 100084,China;Project Supervision Center of National Health Commission of the People's Republic of China,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;Weifang Medical University,Weifang 261053,China;Committee on Medicine and Health,Central Committee of China Zhi Gong Party,Beijing 100011,China;Institute of Inspection and Supervision,Shanghai Municipal Health Commission,Shanghai 200031,China;Shanghai Municipal Health Commission,Shanghai 200031,China;Jiangsu Preventive Medicine Association,Nanjing 210009,China;Changzhou Center for Disease Control and Prevention,Changzhou 213003,China;Collaborative Innovation Center of Social Risks Governance in Health,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [2]浙江省医学科学院,杭州310012 [3]清华大学公共管理学院,北京100084 [4]国家卫生健康委员会项目评价中心,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]致公党中央医药卫生专业委员会,北京100011 [11]上海卫生健康委员会监督所,上海200031 [12]上海市卫生健康委员会,上海200031 [13]江苏省预防医学会,南京210009 [14]常州市疾病预防控制中心,常州213003 [15]健康风险预警治理协同创新中心,上海200032

出　　处：《中国公共卫生》2024年第3期285-289,共5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(2020-2022年)项目(GWV-12)。

摘　　要：目的分析新冠疫情前后中国内地31个省(自治区、直辖市)重大疫情防控激励机制覆盖范围的变化情况,评价激励机制的现状和不足。方法系统搜集中国内地31个省(自治区、直辖市)2000-2020年重大疫情防控相关文件3864篇,摘录激励机制有关字段,计算正、负两种类型激励机制的覆盖程度及包括业务主管部门、专业公共卫生机构、医疗机构以及基层卫生服务机构在内不同类型机构激励机制的覆盖程度,得到各地区的激励机制覆盖范围。采用配对秩和检验分析东、中、西部地区及中国内地31个省(自治区、直辖市)平均水平新冠疫情前后激励机制覆盖范围的变化情况。结果中国内地31个省(自治区、直辖市)平均负激励机制覆盖程度从2020年前的74.19%上升到2020年的76.34%,提升幅度为2.90%(P<0.05)。正激励机制覆盖程度从2020年前的0上升到2020年的22.85%(P<0.001)。业务主管部门、专业公共卫生机构、医疗机构以及基层卫生服务机构的平均水平覆盖程度均有一定提升,提升幅度分别为11.83%、30.77%、42.11%及89.66%,且新冠疫情前后的差异均具有统计学意义。从激励机制覆盖范围看,2019-2020年平均覆盖范围从37.10%上升至49.60%,提升幅度达33.70%(P<0.05)。东部地区覆盖范围提升幅度为47.47%,中部地区覆盖范围提升幅度为27.54%,西部地区提升幅度为25.00%,差异均有统计学意义。结论新冠疫情后中国内地31省(自治区、直辖市)激励机制覆盖范围明显提升,正激励实现从无到有的跨越。Objective To analyze changes in the coverage of incentive measures for promoting major epidemic prevention and control in documents published by governmental and professional departments in the Chinese Mainland before and after coronavirus disease 2019(COVID-19)epidemic of 2020.Methods Through systematically searching websites of government departments and professional institutions in 31 provincial-level administrative divisions(PLADs)of the mainland of China,we retrieved totally 3864 documents(including laws,regulations,standards,rules,proposals,plans,and guidelines)relevant to major epidemic prevention and control published from 2000 through 2020.The paragraphs related to incentive and disciplinary measures for promoting the containment of major epidemic were extracted to calculate region-and institution-specific coverage of the measures in the retrieved documents.Wilcoxon paired rank sum test was adopted to evaluate differences in the coverage of the established measures before and after COVID-19 epidemic of 2020 among various economic regions and administrative/professional institutions.Results The average coverage of disciplinary measures for the retrieved documents increased from 74.19%before 2020 to 76.34%in 2020,with a significant increase of 2.90%(P<0.05);while,the average coverage incentive measures was 22.85%for the documents published in 2020,significantly increased in comparison with no incentive measure presented in all the documents published before 2020(P<0.001).Compared to those before 2020,the national average combined coverage of incentive and disciplinary measures increased significantly by 11.83%,30.77%,42.11%,and 89.66%in 2020,for the documents published by administrative departments,public health institutions,health care institutions,and primary health care institutions,respectively;the national average coverage increased from 37.10%before 2020 to 49.60%in 2020 for the documents published by all the institutions,with an increment of 33.70%;and for the documents published by all the institut

关 键 词：新冠疫情前后比较 重大疫情 激励机制 中国内地 

分 类 号：R181.8[医药卫生—流行病学]