RESUMEN
Objective To analyze the current situation of financing in disease control and prevention constitutions in China, to identify existing problems, to explore potential reasons, and to make policy recommendations accordingly. Methods Financial related indicators, including revenue and expense of disease control and prevention institutions, were collected through questionnaire survey. Moreover, some disease control and prevention institutions were selected for on-site survey. Results The proportion of public health institutions in the Total Health Expenditure had fallen from 7.0% in 2014 to 5.6% in 2018. The proportion of financial compensation in the operation of disease control and prevention institutions was less than 50%. The gap between revenue and expenditure had not been covered completely after the cancellation of three categories of administrative charges. In addition, financing mechanism of public health service funds remained unclear. Conclusion We recommend the strategies, including optimizing financing structure, increasing investment in disease control and prevention, increasing the level of financial guarantee, improving the mechanism of public health service funds, and multi-channel financing.
RESUMEN
Objective To analyze the staff structure, turnover and income of human resources in disease control and prevention institutions(CDCs)at different levels in China, to identify the existing problems, and to make policy recommendations accordingly. Methods A questionnaire survey was used to collect the data on the staff of CDCs at different levels in China from 2016 to 2018. Descriptive analysis and trend analysis were conducted on the number of staff, recruitment and turnover, income and other indicators in the three years. Results A total of 606 CDCs were included in the study. The proportion of job openings was 11.97% in 2018. Although the median proportion of professional personnel and health professional personnel in the CDCs reached the national standard(85% and 70%, respectively), a considerable number of institutions failed to meet the national standard. From 2016 to 2018, staff turnover in the CDCs has been increasing, with a minimum of 0.73(in 2016, municipal CDCs)and a maximum of 10.52(in 2018, provincial CDCs). In the staff who quit the CDCs, the proportion of junior professionals was the highest, while that of medium and senior professional increased gradually. Of them, the proportion of staff with graduate education in eastern China and provincial CDCs was higher than that of undergraduate education, while the proportion of staff with graduation education in other regions also increased. From 2016 to 2018, the average annual income in the CDCs in most regions did not reach the national average wage level of urban employees in health, social security and social welfare field in the same period. In county and district level CDCs in central and western China, personal income in 2018 was even less than the national average wage level in 2016. Conclusion Human resources in the CDCs at different levels in China remains insufficient and unbalanced, which warrants a"supporting policy"mechanism for public health personnel. The loss of the personnel in the CDCs continues to increase, in which the loss of senior professionals become increasingly serious. It raises a new concern to establish and improve the incentive mechanism of public health personnel. Furthermore, personal income in the CDCs is lower than the local average level. It is necessary to set personal income reasonably according to local economic level.