政府监督管理对职业卫生技术服务的影响
Impact of government supervision and management on occupatonal health technical services
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摘要:
原安全监管部门自2010年起负责职业卫生技术服务机构监督管理后，陆续采取改革机构资质管理、技术服务规范指导和执法检查等监管措施以提高机构从业规范性。原国家安全监管总局于2014-2016年对88家次职业卫生技术服务机构开展执法检查时发现了766个问题，依据《职业卫生技术服务机构检测工作规范》将问题分为10类。数据显示，2014年检查和2015年检查时，机构问题数以及这些问题的种类数（以下统称两类平均数）几乎没有差异；2016年检查和之前两年比较，机构的两类平均数下降明显，其中存在现场采样、内部审批培训和采样检测流程、维持资质认可条件、网上公开技术报告等4类问题的机构明显减少，而危害评价和技术报告质量方面出现问题的机构明显增多。从不同资质机构来看，在同一年度，甲级、乙级和丙级机构的两类平均数差异不明显；2016年和之前两年比较，甲级机构及其一次检查组（只检验1次）的两类平均数下降幅度均大于乙级机构。从执法检查效果来看，两次检查组的两类平均数下降幅度明显大于一次检查组。本次检查结果提示加强机构资质管理、技术服务规范指导和执法检查均可不同程度地提高机构从业规范性，但仍有多种问题没有明显减少。建议卫生健康部门稳定政策预期、简化机构资质审批、严格监督执法、优化服务指导。
Abstract: Several regulatory measures such as reforming institutional qualification management, technical service specification guidance, and law enforcement inspection were adopted to improve the standardization of institutional practice since 2010, when former work-safety administratons were responsible for the supervision and management of occupatonal health technical service institutions. The former State Administration of Work Safety found 766 problems during the law enforcement inspecton of 88 occupatonal health technical service insttutons from 2014 to 2016. According to the Specifcaton for Inspecton of Occupatonal Health Technical Service Organizations, the problems were divided into 10 categories. The number of problems and the number of problem categories (two types of average numbers) found at the inspectons in 2014 and 2015 showed almost no difference, while the two types of average numbers found at the inspecton in 2016 were decreased signifcantly compared with last two years. There were less institutions with the four categories of problems such as on-site sampling, internal approval training and detection processes, maintenance of accreditation requirements, and technical reports online disclosure, and more institutions with the problem regarding the quality of occupational hazard assessment and technical reports. From the perspectve of insttutonal qualifcaton, there was no signifcant difference in the two types of average numbers among class-A, class-B, and class-C insttutons at each round of inspection. In 2016, class-A institutions and those with one inspection showed obvious decreases in the two types of average numbers compared with class-B insttutons. From the perspective of the effectiveness of law enforcement inspection, the two types of average numbers of the institutions with two inspections decreased more than those with one inspection. The inspection findings suggest strengthening institutional qualification management, technical service specification guidance, and law enforcement inspection can improve the standardization of institutional practice to varying degrees, but still many categories of problems have not been significantly reduced. It is recommended that health commissions at all levels should stabilize policy expectatons, simplify qualifcaton approval of insttutons, strengthen supervision and law enforcement, and optmize service instructons.
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