健康需要对京沪妇女保健目标动态调整影响
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摘要
目的评价京沪两地妇女健康需要对妇女保健目标动态调整的影响程度,并检验量化指标的可行性。方法系统收集两地公开发布的政策文件中关于目标的表述和发布问题敏感指标信息的权威报告,量化计算目标的动态调整程度;运用Spearman相关、线性回归等方法,分析根据妇女保健需要目标的动态调整程度与孕产妇死亡率之间的关系。结果北京2017年妇女育龄期、孕产期目标的动态调整程度分别为10.0%和25.0%,上海2017年妇女育龄期、孕产期目标的动态调整程度分别为20.0%和25.0%;两地2000—2017年妇保领域目标动态调整程度呈现波动趋势,2000年均为0.0%,2017年分别提高到17.9%和21.3%。两地妇保领域目标动态调整程度与孕产妇死亡率均无相关关系(P> 0.05)。结论京沪两地依据妇女健康需要动态调整目标的程度较低,两地健康需要对妇女保健目标动态调整的影响未充分体现;经验证,本研究采用的量化指标用以评价妇保体系状况是可行的,该方法可推广应用于其他地区和其他公共卫生领域。
Objective To assess the impact of health needs on the adjustment of health goals among women in Beijing and Shanghai and to explore the feasibility of evaluating the impact quantitatively. Methods We systematically collected policy documents and reports on sensitive indicators for maternal health needs and goals published by governmental agencies between 2000 and 2017 and quantified the degree of dynamic adjustment on maternal health goals. Spearman correlation,linear regression and other methods were used to analyze the relationship between health needs-based dynamic adjustment on maternal health goals and the variation in maternal mortality. Results In 2017, the dynamic adjustment ratios of health care goals for the women in childbearing and pregnant/puerperal period were 10.0% and 25.0% in Beijing and were 20.0% and25.0% in Shanghai, respectively. During the period from 2000 to 2017, the dynamic adjustment ratios of maternal health care goals for the women in Beijing and Shanghai increased from 0.0% and 0.0% to 17.9% and 21.3%, respectively. There was no correlation between the dynamic adjustment ratios of health care goals and maternal mortality among the women in Beijing and Shanghai(both P > 0.05). Conclusion The level of health needs-based adjustment on health care goals for the women in Beijing and Shanghai is relatively low and the impact of the health needs on the adjustment of health goals is not obvious.The quantitative indexes adopted in the study are feasible for the evaluation on the status of maternal health care system and could be applied in other researches.
Objective To assess the impact of health needs on the adjustment of health goals among women in Beijing and Shanghai and to explore the feasibility of evaluating the impact quantitatively. Methods We systematically collected policy documents and reports on sensitive indicators for maternal health needs and goals published by governmental agencies between 2000 and 2017 and quantified the degree of dynamic adjustment on maternal health goals. Spearman correlation,linear regression and other methods were used to analyze the relationship between health needs-based dynamic adjustment on maternal health goals and the variation in maternal mortality. Results In 2017, the dynamic adjustment ratios of health care goals for the women in childbearing and pregnant/puerperal period were 10.0% and 25.0% in Beijing and were 20.0% and25.0% in Shanghai, respectively. During the period from 2000 to 2017, the dynamic adjustment ratios of maternal health care goals for the women in Beijing and Shanghai increased from 0.0% and 0.0% to 17.9% and 21.3%, respectively. There was no correlation between the dynamic adjustment ratios of health care goals and maternal mortality among the women in Beijing and Shanghai(both P > 0.05). Conclusion The level of health needs-based adjustment on health care goals for the women in Beijing and Shanghai is relatively low and the impact of the health needs on the adjustment of health goals is not obvious.The quantitative indexes adopted in the study are feasible for the evaluation on the status of maternal health care system and could be applied in other researches.
引文
[1]袁名别,郭炜煜.高绩效政府管理的保障机制与途径选择[J].内蒙古农业大学学报:社会科学版,2005(1):68-71.
[2]彭仕勇.乡镇政府绩效管理研究[D].武汉:武汉大学,2005.
[3]王健,李俊轶.当前投资领域存在的问题、成因和对策[J].福建论坛:人文社会科学版,2013(10):5-11.
[4]夏玉宾.我国服务型政府建设中的制度创新研究[D].西安:电子科技大学,2010.
[5]曾金浪.福建省妇幼保健院产科发展分析与对策研究[D].福州:福建医科大学,2015.
[6]刘继同.健康需要的基本特点与医疗卫生政策涵义[J].中国卫生事业管理,2005(2):68-69.
[7]Parkhurst JO,Penn-Kekana L,Blaauw D,et al.Health systems factors influencing maternal health services:a four-country comparison[J].Health Policy,2005,73(2):127-138.
[8]北京市统计局.2016北京统计年鉴[M].北京:中国统计出版社,2016.
[9]北京市卫生和计划生育委员会.北京卫生计生事业统计公报[EB/OL].[2018-05-03].http://xxzx.bjchfp.gov.cn/tonjixinxi/weishengtongjigongbao/.
[10]上海市卫生和计划生育委员会.上海卫生计生数据[EB/OL].[2018-05-03].http://www.wsjsw.gov.cn/wsj/n429/n432/n1488/n1490/index.html.
[11]阮云洲,吴明.四个县级疾病预防控制机构公共卫生服务项目成本分析[J].中华预防医学杂志,2007,41(4):262-265.
[12]杜亚男.国家基本公共卫生服务项目执行情况研究[D].北京:中央民族大学,2016.
[13]Walsh K.Quality and public services[J].Public Administration,1991,69(4):503-514.
[14]龙俊睿,郭蕊,李胜伟,等.北京市外来务工人员公共卫生服务利用调查[J].中国公共卫生,2014,30(8):998-1001.
[15]杨伟华.加快覆盖城乡居民公共卫生服务体系建设的研究[J].中国医疗前沿,2008(22):34-35.
[16]白鸽,周帅,戴瑞明,等.医学中心城市的内涵及特征研究[J].中国卫生资源,2018,21(1):3-6.
[17]Ellencweig AY.Analyzing health systems:a modular approach[M].London:Oxford University Press,1992.
[18]卫生政策学[M].2版.人民卫生出版社,2013:30-33.
[19]余明洁,LiLi,匡莉.全科医疗转诊体系框架研究[J].中国全科医学,2018,21(4):375-381.
[20]刘晶,王昊君,李京辉,等.以公平正义的视角审视我国基本公共卫生服务均等化[J].卫生软科学,2016,30(12):17-20.
[21]李望晨,张利平,孔雨佳,等.我国妇幼死亡率GM(1,1)与线性回归预测模型研究[J].中国卫生统计,2010,27(4):366-368.
[22]王宏,王芃.孕产妇死亡率的推计及影响因素的分析[J].中国公共卫生,2001(12):101-102.
[2]彭仕勇.乡镇政府绩效管理研究[D].武汉:武汉大学,2005.
[3]王健,李俊轶.当前投资领域存在的问题、成因和对策[J].福建论坛:人文社会科学版,2013(10):5-11.
[4]夏玉宾.我国服务型政府建设中的制度创新研究[D].西安:电子科技大学,2010.
[5]曾金浪.福建省妇幼保健院产科发展分析与对策研究[D].福州:福建医科大学,2015.
[6]刘继同.健康需要的基本特点与医疗卫生政策涵义[J].中国卫生事业管理,2005(2):68-69.
[7]Parkhurst JO,Penn-Kekana L,Blaauw D,et al.Health systems factors influencing maternal health services:a four-country comparison[J].Health Policy,2005,73(2):127-138.
[8]北京市统计局.2016北京统计年鉴[M].北京:中国统计出版社,2016.
[9]北京市卫生和计划生育委员会.北京卫生计生事业统计公报[EB/OL].[2018-05-03].http://xxzx.bjchfp.gov.cn/tonjixinxi/weishengtongjigongbao/.
[10]上海市卫生和计划生育委员会.上海卫生计生数据[EB/OL].[2018-05-03].http://www.wsjsw.gov.cn/wsj/n429/n432/n1488/n1490/index.html.
[11]阮云洲,吴明.四个县级疾病预防控制机构公共卫生服务项目成本分析[J].中华预防医学杂志,2007,41(4):262-265.
[12]杜亚男.国家基本公共卫生服务项目执行情况研究[D].北京:中央民族大学,2016.
[13]Walsh K.Quality and public services[J].Public Administration,1991,69(4):503-514.
[14]龙俊睿,郭蕊,李胜伟,等.北京市外来务工人员公共卫生服务利用调查[J].中国公共卫生,2014,30(8):998-1001.
[15]杨伟华.加快覆盖城乡居民公共卫生服务体系建设的研究[J].中国医疗前沿,2008(22):34-35.
[16]白鸽,周帅,戴瑞明,等.医学中心城市的内涵及特征研究[J].中国卫生资源,2018,21(1):3-6.
[17]Ellencweig AY.Analyzing health systems:a modular approach[M].London:Oxford University Press,1992.
[18]卫生政策学[M].2版.人民卫生出版社,2013:30-33.
[19]余明洁,LiLi,匡莉.全科医疗转诊体系框架研究[J].中国全科医学,2018,21(4):375-381.
[20]刘晶,王昊君,李京辉,等.以公平正义的视角审视我国基本公共卫生服务均等化[J].卫生软科学,2016,30(12):17-20.
[21]李望晨,张利平,孔雨佳,等.我国妇幼死亡率GM(1,1)与线性回归预测模型研究[J].中国卫生统计,2010,27(4):366-368.
[22]王宏,王芃.孕产妇死亡率的推计及影响因素的分析[J].中国公共卫生,2001(12):101-102.