| BackgroundIn recent years,public health emergencies such as SARS,avian influenza and the novel coronavirus pneumonia have occurred frequently.Countries have begun to attach importance to emergency management and constantly improve their emergency management systems.Among the many subjects of emergency management,the Center for Disease Control and Prevention(hereinafter referred to as the CDC)is a professional organization dealing with public health emergencies.Its work responsibilities run through the whole process of event handling.It also means that the continuous improvement of its emergency capacity is the key to promoting the development of our health emergency system construction.The novel coronavirus pneumonia has exposed the deficiencies and defects of China’s disease control system,and also brought new opportunities for the development of the CDC.At present,under the strong support of the country,the construction of Chinese health emergency management system has entered a new development stage,and the disease control system has been thoroughly reformed.But in this process,its emergency capacity has been greatly developed?Is the funding and personnel structure in place?Is it running smoothly?Does it meet the expected effect?Answering these questions requires a thorough investigation and assessment of the CDC’s emergency response capabilities.Health emergency capacity assessment is an important way to promote the normal management of health emergency.Since the 1990s,there has been a lot of evaluation work on emergency ability in foreign countries.Our research in this field is late.Most of the current research belongs to the theoretical research or the research on emergency ability.In this context,it is particularly important to analyze the current situation of health emergency capacity of CDC,find out the advantages and disadvantages in the construction of various aspects,put forward improvement suggestions for existing problems,and promote the continuous improvement of its emergency capacity.ObjectiveThis paper analyzed the current situation of public health emergency capacity building of county-level CDC in Shandong Province,combined with SWOT analysis,found out strategies for improving health emergency capacity,and put forward corresponding countermeasures and suggestions to provide empirical evidence for the development direction and focus of CDC in the future.MethodsThe method of literature research,field investigation,descriptive epidemiology,SWOT analysis and other methods are used.Questionnaires were designed for county-level CDC,including system construction,emergency team,training and drills,equipment and materials reserve,monitoring and early warning,emergency response,education,scientific research and aftercare evaluation in 8 aspects.In August 2022,a field survey was carried out on 87 county-level centers for Disease Control and Prevention in Shandong Province(data from 2021 to the date of the survey).Descriptive epidemiological methods were used to analyze and evaluate the status quo of health emergency response capacity building of the survey institutions.At the same time,the strengths,weaknesses,external opportunities and challenges faced by the centers for Disease Control and Prevention were discussed with SWOT analysis.ResultsFinally,84 questionnaires were collected and included into 80 county-level centers for Disease Control and prevention after eliminating invalid questionnaires.The results showed that the rates of health emergency plan and emergency technical work plan were 100%and 85%,respectively.The rate of independent emergency response was 51.25%;100 percent of the centers for Disease Control and Prevention set up health emergency teams,and 67.50 percent set up expert banks.90%to 100%of the CDC’s existing team equipment and material reserves(including planned reserves)can meet or partially meet the needs of the work;96.25%formulated annual training plans for health emergency preparedness,with an average of 4 emergency preparedness training sessions in 2021.93.75%formulated annual plans for health emergency preparedness exercises,and 100%conducted health emergency preparedness exercises,with an average of 3 in 2021.81.25%of the centers for Disease Control and Prevention have formulated a system for regular analysis of public health emergencies and a working mechanism for risk assessment,and 85%carry out regular daily risk assessment.90%of the Centers for Disease Control and Prevention have developed public information and education materials for health emergency response;17.50 percent of the CDC conducted health emergency-related research,and 20 percent hosted or participated in health emergency-related exchanges and cooperation.56.25%formulated the case-assessment system for health emergency response,and 86.25%formulated the annual summary system for health emergency response.28.75%and 25.00%of the cases of reward and punishment and subsidy to emergency personnel were respectively.Analysis of variance showed that there was no statistical difference in the total scores of emergency response ability of CDC in eastern,central and western China(F=2.113.P=0.128).There were differences in training and exercise(F=3.446.P=0.037).LSD test showed that the difference was mainly between the eastern and central regions(P<0.05).The total scores of county,county-level and district-level CDCS were statistically different(F=4.355,P=0.016).Multiple comparisons showed that the total scores of county and county-level CDCS were different.There were differences in monitoring and early warning at all levels(F=3.755,P=0.028),which were mainly found to be differences between county level and county-level city.There were statistical differences in the total score of emergency response capacity of CDC under the number of permanent residents in different jurisdictions and in the aspects of system construction,emergency response team,equipment reserve,monitoring and early warning,education,scientific research and aftermath assessment(P<0.05).Advantages of CDC:location advantage;The top-level design of system construction is clear;Advantages of timeliness and standardization in emergency response.Disadvantages:the total number of personnel is insufficient,the shortage of professional talents;Insufficient financial input;Laboratory testing ability is not strong.External opportunities:The government attaches great importance to the construction of public health system:Increased public awareness of public health;The requirement of "healthy and strong province";Challenges:The long-term concept of"emphasizing medical treatment over prevention" has resulted in the low social status of CDC;The task remains heavy and the responsibility heavy.Conclusions and suggestionsThe emergency response framework system of county-level CDC in Shandong Province has been basically established and gradually improved,but the overall emergency response capability still needs to be improved.The strengths of emergency response capability mainly include emergency response plan,emergency team,equipment reserve,monitoring and analysis and emergency response,while the weaknesses mainly include inadequate training and exercises,risk assessment,scientific research and aftermath assessment.The development of health emergency response capacity of CDC is more balanced in the eastern,central and western regions.County-level CDC has a lower capacity than county-level city and district-level CDC,while the emergency response capacity of the district with a large population is stronger.Based on the above conclusions,the following suggestions are put forward:(1)Strengthen emergency personnel reserve and improve the comprehensive strength of emergency team;(2)Strengthen health education and scientific research;(3)Strengthen in-process,post-event and stage evaluation;(4)Allocate health resources rationally and give proper preference to less developed areas;(5)Establish a long-term and stable fund investment guarantee mechanism;(6)Promote the institutional reform of CDC and accelerate standardization construction. |
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