The Study Of Management Model Of Infectious Diseases Control And Prevention For Floating Population In Beijing

BackgroundAccompanying with the population flow, the probability of infectious diseases increase synchronously, thus it may appear some careless of management modal of infectious disease control and prevention (IDCP), which is based on household registration system; the life conditions and work environment of floating population is much worse than residents, which poses the possibility to source of infection and route of transmission. According to the above three aspects, it shows that floating population are much easier to suffer epidemics than residents, besides, the infection outbreak not only does harm to floating population themselves, but also has become a threat to the economy and the social development of the city that they visited. Therefore, whether based on the consideration of protecting floating population's health and improving their diathesis, or based on the consideration of protecting the public health safety of inflows area, or else facing to future, aiming to realize the harmony society, we should improve the management of IDCP, and pay much attention to it.Objective: To analyze current status and problems of infectious disease control and prevention for floating population in Beijing over the angle of the policy making & construction, discuss rational management modal of IDCP, and provide suggestions .Methods1. Questionnaire survey, in-depth interview, focus-group research, literatures, situation analysis were applied to analyze the current status of IDCP in Beijing;2. Questionnaire survey, contrast analysis, value analysis and situation analysis were used to find the general situation of floating population's infection diseases and the difficulties of management; also the implementation and resources allocation of IDCP 3. Literatures, value analysis and situation analysis were applied to table a proposal of the basic goal of IDCP for floating population, and also the suggestions about how to improve the management modal of IDCP.Results1. Difficulties of IDCP for floating population(1) External public health environment of floating population is not satisfied Most of floating population have jobs which are labor intensive, full of health risk factors, and their live conditions are much worse than residents; besides, their income is lower, most of which are on the stage of meeting the basic needs of living; a majority of floating population are lack of health insurance, thus the capability of anti-risk is less delicate.(2) Accessibility of public health service for floating population is worseDue to the limit of current health service system, the coverage of public health service for floating population is not enough. Meanwhile, under a variety of limits, the level of knowledge regarding public health service is available to rise; the conception of utilization of public health service initiatively should be built up. Most of floating population come from the areas where the economic conditions are not very good, and the level of health service are much low either. On the one hand, they contact a lot of risk factors of infection; on the other hand, they live in city without any health insurance. Those above three aspects make up of in-depth mechanism of difficulties for IDCP.2. Current status of IDCP for floating population(1) Course of policies of IDCP for floating populationFrom 1999 to present, the history of police system of IDCP can be divided into three phrases: break the ice and development, restriction and adjustment, transformation from management to service. Generally, the policy system was improving much better, but standing policy are still at the level of practice without a whole and strategical guideline, thus the management modal seems like"project-oriented", which is difficult to solve the problems of IDCP for floating population.(2) The main structure of management modal of IDCPAmong the structure system, government is on the top ground, which can be divided into three categories: command & cooperation departments, principal departments and support& assistance departments. Relationships among those departments is with characters that is multi-dimension, separated, dependent, across-adjusted, common willing and cooperative, and those characters make communication & cooperation the key parts of IDCP for floating population.3. Polices Implement & resources allocation(1) Polices Implement of IDCP for floating populationThe contents of policies includes infection surveillance, immunity vaccine, health education, health inspection, reporting and isolation treatment; there are 26 departments which are related to IDCP, the forms of cooperation among those departments include united documents, information communication, joint conference and united inspection. The above four methods are temporary, and lack of specific assessment standard.(2) The human resources allocated unequal, and some related organizations lacked necessary human resource. Health administrations lack necessary finance support, and the responsibility of investment between municipal and county are not clear enough.(3) Basic information resource of IDCPHealth administrations cannot distinguish floating population and residents by current infection reporting system; temporary residency registration bacomes more and weaker, which make information of floating population difficult to be acquired.Conclusions1. It needs to be realized that three basic goals of improving public health service for floating population. The first goal is to make most of floating population healthy; secondly, improve the equality of health financing; finally, rise the responsibility of health system for floating population.2. Adjust distribution and cooperation among related organizations (1) As the only department which takes the responsibility of floating population service& management, committee of floating population administration should play a core role of communication among all kinds of related departments.(2) Administrative Accountability of communication and cooperation should be conducted.(3) Mechanism of reporting needs to change from single-oriented to multi-oriented, in order that the health department can know correlative information about infectious diseases.3. Optimize the resource allocation of IDCP policies(1) Financial shift payment system should be adjusted. Besides the administration running expenses and revenue return, project outlay of IDCP for floating population needs to be provided by municipal financial system.(2) Input budget practice needs to be changed into the out budget which is performance-oriented.(3) Staff of the recruitment plan of IDCP should be increased by adjusting the recruitment plan, or by contract of employment.(4) Medical aid of some severe infectious diseases for floating population needs to be increased.(5) Laws of health inspection should be supplemented some forcible issues that is related to infection surveillance and reporting.4. Improve the information system of floating populationThe information system of floating population should be improved in the following three aspects: (1) Temporary residency registration needs to affixed functions of services; (2) Information systems belongs to different administrative departments should be pooled; (3) Residents and non-residents need to be listed respectively in infection reporting system.