| 1. Study Objectives and Significances(1) To meet the need of disease prevention and control system reform and constructionSARS (Severe Acute Respiratory Syndrome), which broke out in 2002, attacked 266 counties of 24 provinces in China and resulted in 5327 cases and 349 patients died of SARS. This contagious disease threatened the life safety badly, influenced the economic development, social stability and external intercourse. Which made the Central Government and common people realized that Chinese disease prevention and control system was weak and indispensable to rebuild the system. Therefore, the State Council put forward the objective of rebuilding Chinese disease prevention and control system in about 3 years. In order to realize this objective, the experts in policy research, policy makers and executors of disease prevention and control developed the strategetic research on building the system of disease prevention and control in China. Firstly, taking the public health product as the yardstick, to define the functions of Chinese disease prevention and control system and the concrete functions of CDCs at state, province, city and county levels and the health prevention and care organizations at grass roots. Secondly, using the advanced administrative mode of the developed countries as the reference, to reform the current administrative system of disease prevention and control and bring forward the suggestion on establishing Disease Prevention and Control Bureau in China. Finally, in order to fulfill the defined public functions and projects, to measure the allocation criteria of manpower, expenses, material resource and institution construction for disease prevention and control institutions at all levels.At present, Chinese disease prevention and control system was improved step by step. the institution functions were defined, and the research of organization construction was completed. the allocations of manpower, expenses and material resource and the work conditions were improved to a certain extent. But how to allocate the definite manpower, expenses and material resource for one project of disease prevention and control rationally? How to accomplish the defined functions in the whole institution, some sections or one concrete project? These questions need to be resolved through making a systemic and standardized technology and management procedure which instruct us to allocate the resources of disease prevention and control reasonably, among of them including manpower, expenses and material resource. To carry out the management on three administrative levels which are the whole institution, section and project to accomplish the public functions of disease prevention and control in deed.(2) To enhance the capability of dealing with the public health emergency in ChinaThere are many problems and challenges in the dealing with the public health emergency in China. In 2002, the society began to realize the weakness of the Chinese disease prevention and control system because of SARS. The researchers have put forward many problems of the system, for example, the lack of manpower, expenses, material resource and the Standardizations of the jobs.The study focus on every disease prevention and control projects and selects the dealing with the public health emergency as the objective to develop a frame and essentials of the workbook, and to study the method and procedure in developing the workbook. Based on the guidance other projects could develop the respective workbooks. The study select the city and country disease preventing and controlling institutions as the research objectives to develop the workbook, which engage in the technical and administrant work. Thus, with the workbook guidance, the workbooks of other administrative levels institutions such as the nation, province level that just have the administration functions and the grass roots which include the towns, could be written.2. Research methods and Data SourcesThe study applied "Structure-process-outcome" of "A Macro-Model of Health System" to develop a frame and essentials of the workbook on how to dealing with the public health emergency in China. With the frame and essentials guidance, using the method of "Qualitative and Quantitative Multi-demonstration" to develop and demonstrate all contents of the workbook. We adopted the methods of "Benchmarking" to study the manpower, expenses and equipment demand of dealing with the public health emergency in China, and creating the method, procedure, the formulas and approaches to measure the human, expenses demand of dealing with the public health emergency. The study also used the method of "Gap analysis between practice and ideal" to analyze the difference between the ideal conditions in practice and the requirement of the book.Data-collected methods include the literature review and induction, institution investigating and basic condition survey, focused interview and focused group study, routine statistic data collection and the simulation and operation in practice, etc. This study selected 10 provinces including Hubei, Hunan, Jiangxi, Jiangsu, Zhejiang, Guangdong, Heilongjiang, Shandong, Gansu and Shanxi as the surveyed sample provinces. From these provinces, selecting 83 institutions at city level and 85 institutions at county level.During developing the workbook of dealing with the public health emergency in china, the study consulted 540 person-times of 103 experts to improve it again and again. To survey 168 sample institutions to perfect and demonstrate it. Besides this, the study applied it to 5 institutions at city level and 6 ones at county level to demonstrate its applicability. The study collected suggestions put forward by 5 institutions from July to December in 2005 and perfect the workbook further again.3. Main study results(1) To develop a workbook on dealing with the public health emergency◆To form principles on how to develop the workbook—Legitimacy—Assignment is assigned according to its responsibility—Giving emphasis to work procedures, work approaches and work evidence—pay more attention to the work can not only guide work practice at present but also meet the work development need(2) The frame and essentials of the workbook◆Summarization of the workbookSummarization of the workbook is preface of the book, it synthetically generalizes some contents, including—To simply illuminate the aim and significance of dealing with the public health emergency, to develop general work objective.—To describe all work items that have to performed in order to realize the general work objective.—Taking general objective realization as center, to develop work items flow chart according to the principle of tertiary prevention on the basis of work experience and theoretic knowledge.◆Detailed part of workbookThe detailed part of the workbook expatiate the work target and tasks, work contents measure and method, work procedure and approaches, technical documents that could guide practice of dealing with the public health emergency, procedure quality index and the keys of quality control, work amount and frequency criteria and work performance assess index. (3) Gap analysis between current work and workbook criterion and influence factors researchThe rate of achieving procedure quality index and its criterion of the workbook at present is 71.6%. The rate of accomplishing work amount and frequency criteria of the workbook at present is 68.6%. Making influence factors analyses to find that there are common influences factors result in the low degree of quality reaching and quantity accomplishing. The first influence factor is short of work expenses, the second is insufficiency work human power, and the third is absence of apparatus and equipments. Other influences factors are social institutions concerned aren't perfect, assignments and tasks aren't definite and cooperation between social institutions or departments concerned isn't smoothly.(4) Sustaining System study of the workbook◆Organizational guarantee, Institutional guarantee research See to see Appendix 1＜Workbook on dealing with the public health emergency in China＞.◆Work manpower demand researchThe work manpower for all CDC at city level nationwide is 2036. The work manpower for all CDC at county level in China is 11570.◆The expenses demand researchWork expenses of all CDC at city level nationwide is 94.30 million Yuan (RMB) every year, Work expenses of all CDC at county level nationwide is158.69 million Yuan (RMB) every year.◆Apparatus and equipment demand researchThe equipments for CDC at city level are 46 kinds and for CDC at county level are 48 kinds◆Social departments and institutions concerned and their responsibility and basic assignmentsThere are more than 7 social departments and institutions concerned to the item of dealing with the public health emergency. They are disease prevention and control institutions for example CDC at city and county level, all kinds of hospitals and health care institutions at all levels, health administration departments at all levels. Any items can't complete by any single department or institution. The leading department or institution that takes charge of a work item is different.In dealing with the public health emergency, average rate of function and assignments of social departments or institutions above were accomplished is 71.1%. Disease prevention and control institutions such as CDC at city and county level highest (the rate is 80%～90%), the second is the health administration departments at all levels, all kinds of hospitals and health care institutions at all levels (the rte is 60%～80%). (5) Effect evaluation and analysis of the workbookThe new developed workbook is more systemic, logical and comprehensive on the whole. The contents of the workbook are more detailed and elaborate than the old workbook of 2001 year edition. Among the 14 work items, there are 7 items preserved and 7 items increased. As for the work performance assess indexes, the workbook increased 27.From the surveyed technical personnel engaged in dealing with the public health emergency, a series of procedure quality indexes and quality control keys of the workbook was enough to grasp and control the quality of dealing with the public health emergency (93.6% agreed of all). A series of amount and frequency criteria of workbook was enough to complete corresponding work task and realize corresponding work target (94.3% agreed of all). A series of work performance assess indexes was enough to comprehensive corresponding work effect and performance (94.4%% agreed of all). In conclusion, the developed new workbook could achieve good result and effect if it was put in practice.4. Innovation and applicationThe study applied "Structure-process-outcome" of "A Macro-Model of Health System" to develop a frame and the essentials of workbook on how to dealing with the public health emergency in China. This study consulted 22 experts to perfect, demonstrate and define the frame and the essentials. The frame and essentials of the workbook could help to develop many workbooks on other work in the filed of disease prevention and control. All these will make for disease prevention and control system standardization and make a great progress in the future.During developing the workbook of dealing with the public health emergency in China, the study consulted 540 person-time of 103 experts to perfect and demonstrate it, surveyed 83 institutions of dealing with the public health emergency at city level and 85 institutions at county level to perfect and demonstrate it and applied it to 5 ones at city level and 6 ones at county level to demonstrated its applicability and prefect it further. In conclusion, "Qualitative and Quantitative Multi-demonstration" was adopted during the course of developing the workbook to make sure its acceptability and feasibility. Meanwhile, the effect evaluation and analysis of the workbook make sure its effect.The paper developed a systemic technical workbook on how to dealing with the public health emergency better for the first time, which presents specific work goal and task, detailed work contents, work measures and methods, logical work procedure and approach, a series of procedure quality indexes and keys of quality control, a series of amount and frequency criteria of work. a series of technical document that could guide practice of dealing with the public health emergency and a series of work performance assess indexes. The workbook put forward a criterion and lay the foundation for dealing with the public health emergency project management.To use the methods of "Benchmarking" to study human, expenses and equipment demand of dealing with the public health emergency in China. The study created a measure method and procedure, translated these into formulas and approaches to measure human, expenses and equipment demand of dealing with the public health emergency account to services target number. These formulas and approaches were demonstrated through simulation measure. The paper used these to measure human, expenses and equipment demand to dealing with the public health emergency of all institutions at city level and all institutions at county level countrywide. These outcomes bring forward a criterion and lay the foundation for the dealing with the public health emergency project management.The study make clear the organizational guarantee, institutional guarantee, the social departments and institutions concerned and their responsibility and basic assignments, these could make the workbook to be put in practice successfully and smoothly.
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