Evaluation of the ten-year effect of implementing national basic public health services in Shanghai

Objective Since Shanghai began to explore the establishment of the system of basic public health services in 1997, it has gradually established and improved a network system of basic public health services. By combing the data of basic public health services in the past ten years, we can obtain a general understanding and grasp of the implementation effects of Shanghai's basic public health services. What's more, by summarizing the characteristics of Shanghai's basic public health services, we could put policy suggestions forward for more effective provision of health services in the later period. Methods Data on the implementation of basic public health services in Shanghai from 2009 to 2019 were collected. Through the annual longitudinal analysis, the icons which could directly reflect the specific changes and the overall trend of various indicators in the past ten years were obtained. The Wilcoxon rank test was used to compare the city's comprehensive promotion of family doctor system before and after the index value difference. Results The number of national basic public health services implemented by Shanghai had always been 100% over the years. In the past ten years, the number of residents filing health records had increased year by year to 19.920 1 million. The number of services for key management objects such as women and children, patients with hypertension and diabetes mellitus all reached the level required by the state. The maternal mortality rate dropped to 3.51/100 000, and the infant mortality rate dropped to 3.06‰. The management rate of children's health reached 98.47%. The management rates of hypertension and type 2 diabetes mellitus were 84.77% and 87.37%, respectively. Wilcoxon rank sum test showed that the implementation of the family doctor system was due to the reduction of maternal mortality, the decrease of infant mortality and the improvement of early pregnancy registration rate, postpartum visit rate, blood pressure control rate of hypertension management population, etc. The differences were statistically significant(all P<0.05). Conclusion Shanghai has achieved remarkable results in the implementation of basic public health service projects, but it still needs to be improved in the standardization of electronic health records, the supervision and assessment mechanism of public health funds, and the strengthening of the introduction of public health service personnel.