Assessing health emergency response capacities of centers for disease control and prevention in China – research methods and results: a literature-based analysis
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摘要:
目的 分析中国疾病预防控制机构卫生应急能力评估现状,为明确卫生应急能力评估标准提供参考依据。 方法 采用复合检索式在中国知网(CNKI)数据库和Web of Science数据库核心合集系统检索并收集2003年1月1日 — 2021年10月31日公开发表的疾控机构卫生应急能力评估的相关中英文文献,并采用内容分析法、共词聚类法和问题严重程度序位法归类文献中提及的评价指标,明确各疾控机构在应急能力建设方面面临的问题。 结果 纳入的93篇文献中,有75篇文献采用问卷调查的方法进行研究,且有70篇文献以某一地区疾控机构作为调查对象;各项研究从不同维度出发建立指标体系,目前尚缺乏统一的规范或标准;共词聚类法分析最终归纳出应急准备(8个指标)、监测预警与风险评估(2个指标)、应急响应(3个指标)和组织机构(2个指标)四大类共15个主要评估指标;按严重程度排序,各级及各地区疾控机构的卫生应急能力存在的最严重问题均为应急队伍,其次是突发公共卫生事件规范处置、经费支持与保障、物资储备、培训与演练、科研能力、预案与技术方案等方面的问题。 结论 目前中国尚未建立有关应急能力评估的统一方法、考核标准、评价体系,难以开展比较和长期监测,建议国家统一构建和确定各层级疾控机构卫生应急核心能力评价工具及标准以确保我国各项应急能力监测和评估工作的有效开展。 Abstract:Objective To analyze current situation of assessment on health emergency response capacity of centers for disease control and prevention (CDCs) in China and to provide evidence for developing standards for the capability evaluation. Methods We retrieved relevant studies published in Chinese or English from January 1, 2003 to October 31, 2021 via searching Chinese National Knowledge Infrastructure (CNKI) and Web of Science database. Content analysis, co-word clustering and significance assessing were used in sorting and categorizing the information on evaluation indicators adopted and critical issues of the response capability mentioned in the studies. Results Of the 93 articles finally included in the analysis, 75 were studied using questionnaires and 70 were investigated by a regional CDC. Various index systems were used but no unified framework or standard was adopted in the studies. Based on co-word clustering analysis, four dimensions of the response capability of the CDCs were evaluated in the studies: emergency preparedness assessed by 8 indicators, monitoring/warning and risk assessment by 2 indicators, emergency response by 3 indicators, and organization by 2 indicators, respectively. As considered in the studies, the most important issue to be promoted in the CDCs′ response capability was the establishment of emergency workforce and rapid response team, followed by other main issues including standardized management on public health emergency, financial support, material reserve, staff training and simulation practice, related research, and development/improvement of preparedness plan and technical guidance. Conclusion The uniformed framework, standardized assessment criteria and index system are not yet established for the evaluation on CDCs public health emergency response capability nowadays in China and the situation needs to be concerned by national administrative departments. -
表 1 纳入文献基本特征
研究对象 文献数 普通期刊数量 核心期刊及以上数量 硕博论文数量 n % n % n % 不同级别疾控机构 省级疾控机构 16 7 43.75 5 31.25 4 25.00 市级疾控机构 47 32 68.08 10 21.28 5 10.64 县级疾控机构 68 44 64.71 15 22.06 9 13.23 不同地区疾控机构 东部疾控机构 42 28 66.66 7 16.67 7 16.67 中部疾控机构 27 10 37.04 11 40.74 6 22.22 西部疾控机构 24 15 62.50 7 29.17 2 8.33 表 2 中国不同级别疾控机构卫生应急能力存在问题的严重程度序位
评估指标 省级 市级 县级 严重程度 序位 严重程度 序位 严重程度 序位 应急准备 应急队伍 0.199 1 0.182 1 0.185 1 物资储备 0.073 7 0.106 3 0.081 6 应急检测能力 0.077 6 0.087 6 0.119 3 培训与演练 0.120 2 0.090 5 0.105 5 经费支持与保障 0.108 3 0.097 4 0.115 4 预案与技术方案 0.066 8 0.065 7 0.122 2 应急管理制度 0.023 12 0.024 12 0.025 12 科研能力 0.041 10 0.109 2 0.028 10 监测预警与风险评估 监测预警 0.086 5 0.059 8 0.065 7 风险评估 0.027 11 0.030 11 0.003 15 应急响应 突发公共卫生事件规范处置 0.088 4 0.052 10 0.062 8 风险沟通 0.010 15 0.019 13 0.025 13 事后评估 0.021 13 0.011 15 0.005 14 组织机构 应急科室 0.043 9 0.053 9 0.031 9 领导小组 0.019 14 0.015 14 0.027 11 表 3 中国不同地区疾控机构卫生应急能力存在问题的严重程度序位
评估指标 东部地区 中部地区 西部地区 严重程度 序位 严重程度 序位 严重程度 序位 应急准备 应急队伍 0.177 1 0.192 1 0.215 1 物资储备 0.086 4 0.094 5 0.146 2 应急检测能力 0.082 6 0.099 4 0.065 5 培训与演练 0.103 3 0.119 3 0.132 3 经费支持与保障 0.086 5 0.139 2 0.110 4 预案与技术方案 0.076 7 0.074 6 0.062 6 应急管理制度 0.020 14 0.025 11 0.032 10 科研能力 0.035 10 0.036 9 0.029 11 监测预警与风险评估 监测预警 0.061 8 0.069 7 0.024 12 风险评估 0.031 12 0.013 14 0.016 13 应急响应 突发公共卫生事件规范处置 0.125 2 0.060 8 0.062 7 风险沟通 0.024 13 0.016 13 0.011 14 事后评估 0.005 15 0.013 15 0.005 15 组织机构 应急科室 0.054 9 0.031 10 0.045 8 领导小组 0.035 11 0.018 12 0.044 9 -
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