CAJ | 학술논문

目的：了解合肥市慢性病防控服务实施现状，为推进该市慢性病防控工作提供参考。方法横断面调查。采用自拟问卷并结合现场检查/核查工作档案的方式，对市辖疾病预防控制中心（ CDC）进行普查，并依据行政区划对CHSI进行分层抽样调查。结果共计8家CDC和159家CHSI （占调查时已建CHSI的80％）进入调查，有效应答率分别为100．0％和94．3％（150家）。对于慢性病防控工作，8家CDC全部制订有规划，设有专用场所、总负责人和专管人员；发挥指导和管理作用的工作领域覆盖情况：慢性病监测（7家）、死因监测（7家）、高危筛查（6家）、流行病学调查（4家）、社区综合干预（6家）和干预效果评价（5家）。150家CHSI：85％以上有总负责人、有工作计划并开展了社区动员；但仅一半设立了专用场所，仅17．3％（26家）设立了慢性病科；防控项目实施覆盖率较高的是慢性病登记/管理98．0％、建立健康档案94．7％，其次是社区干预86．0％、慢性病监测80．7％和高危筛查77．3％；干预效果评价覆盖率最低（33．3％）。存在的问题主要有：CDC对慢性病防控工作的指导和管理作用没有充分发挥；慢性病调查和监测系统尚不健全；防控服务项目的实施和干预涉及病种有限，对危险因素的干预较少。结论合肥市慢性病防控工作组织管理得到加强，但防控服务的执行能力和水平存有较大提升空间。
목적：료해합비시만성병방공복무실시현상，위추진해시만성병방공공작제공삼고。방법횡단면조사。채용자의문권병결합현장검사/핵사공작당안적방식，대시할질병예방공제중심（ CDC）진행보사，병의거행정구화대CHSI진행분층추양조사。결과공계8가CDC화159가CHSI （점조사시이건CHSI적80％）진입조사，유효응답솔분별위100．0％화94．3％（150가）。대우만성병방공공작，8가CDC전부제정유규화，설유전용장소、총부책인화전관인원；발휘지도화관리작용적공작영역복개정황：만성병감측（7가）、사인감측（7가）、고위사사（6가）、류행병학조사（4가）、사구종합간예（6가）화간예효과평개（5가）。150가CHSI：85％이상유총부책인、유공작계화병개전료사구동원；단부일반설립료전용장소，부17．3％（26가）설립료만성병과；방공항목실시복개솔교고적시만성병등기/관리98．0％、건립건강당안94．7％，기차시사구간예86．0％、만성병감측80．7％화고위사사77．3％；간예효과평개복개솔최저（33．3％）。존재적문제주요유：CDC대만성병방공공작적지도화관리작용몰유충분발휘；만성병조사화감측계통상불건전；방공복무항목적실시화간예섭급병충유한，대위험인소적간예교소。결론합비시만성병방공공작조직관리득도가강，단방공복무적집행능력화수평존유교대제승공간。
Objective To investigate the implementation status of chronic diseases prevention and control ( NCD-PC) in Hefei,and to provide reference for promoting the future work .Methods Cross-sectional study was used .Questionnaire combined with on -site inspec-tion/verification working files were used to conduct a census on all Centers for Disease Control and Prevention (CDC) in Hefei,and a strati-fied sampling survey on community health service institutions ( CHSI) and related personnel .Results 8 CDCs and 159 CHSIs were investi-gated,the rate of effective response were 100%and 94.3%,respectively.All CDCs has made NCD-PC plans,set up a special place and des-ignated an overall responsibility and full -time management personnel;the CDCs have developed such NCD-PC works as NCD monitoring , death-surveillance,high-risk screening,epidemiological investigation ,community comprehensive intervention and intervention effect evalua-tion.Among the 150 CHSIs,over 85%has designated an overall responsibility ,made NCD-PC plan and carried out community mobilization;but,only a half of them have a special place for NCD-PC and only 24 CHSIs set up a NCD department .The implementation coverage rate of specific service projects as follows:the highest were patient registration and management 98.0%and establishing health files 94.7%,followed by community intervention 86.0%,monitoring 80.7%,high-risk screening 77.3%,the lowest was intervention effect assessment 33.3%.The existing problems:the CDC has not give full play to guide and manage the NCD-PC work in CHSI;the system of chronic monitoring and inves-tigation was not yet perfect;the current programs of NCD-PC were mainly limited to hypertension ,diabetes mellitus and malignant tumor;the utilization rate of surveillance data was low .Conclusions The organization and management of Hefei NCD-PC have been strengthened ,but the executive ability and level of NCD-PC have a big space for improvement .