摘要
目的:分析京沪两地妇女保健管理与监控机制健全对体系的影响与异同,并验证量化评价的可行性。方法:穷尽收集两地公开发布的妇保管理制度文件,在管理与监控机制全面性、权威性和可行性进行分析的基础上,综合形成量化指标"管理与监控机制的健全程度";运用Spearman相关、线性回归等方法,分析该指标与孕产妇死亡率之间的关系。结果:目前北京、上海两地管理与监控机制健全程度分别为33.4%与35.1%,其中机制权威程度(59.6%vs58.7%)较好,而齐全程度(23.7%vs27.6%)与可行程度(17.8%vs19.7%)较低。从趋势变化看,两地妇女保健管理与监控机制健全程度一直稳定提升,与孕产妇死亡率呈现负相关关系(P<0.05)。结论:适宜的妇保体系应"具有全面、权威、有效的管理与监控机制"。两地重视管理与监控机制建设,机制健全能够促进妇女健康结果的改善,上海更为明显。职责不清晰不可考核已成制约两地妇保体系管理与监控机制发挥作用的瓶颈。经验证,本研究综合量化评价管理与监控机制健全程度基本可行。
Objective The aim of this study is to analyze the impacts and differences between maternal health management and monitoring mechanisms in Beijing and Shanghai, and to verify the feasibility of quantitative evaluation. Methods Exhausting the collection of the maternal insurance management system documents publicly released in the two places, based on the analysis of the comprehensiveness, authority and feasibility of the management and monitoring mechanism, comprehensively form the quantitative indicators "the soundness of the management and monitoring mechanism". The health system macro model, Spearman correlation, linear regression and other methods were used to analyze the relationship between the results and maternal mortality. Results The health management and monitoring mechanism of women in the two places has been steadily improved, showing a significant negative correlation with maternal mortality(P<0.05). At present, the scores of Beijing and Shanghai are 33.4% and 35.1% respectively, of which the comprehensive degree of management and monitoring mechanism(84.1% vs 87.0%) and authority(59.6% vs 58.7%) are better, while management and monitoring mechanism The viability(17.8% vs 19.7%) is lower. Conclusion "Acomprehensive, authoritative and effective management and monitoring mechanism" is an important criterion for evaluating the operation of the system. Unclear responsibilities can not be assessed has become a bottleneck restricting the role of the management and monitoring mechanisms of the Maternal health care system in the two places. It has been verified that the quantitative indicators used in this study are comprehensive, objective, scientific and comparable, and it is feasible to evaluate the status of the Maternal health care system.
出处
《中国卫生事业管理》
北大核心
2019年第6期466-469,共4页
Chinese Health Service Management
基金
上海市加强公共卫生体系建设三年行动计划(2015年-2017年)项目“上海现代化国际大都市公共卫生绩效体系构建”(GWIV-32)
关键词
管理与监控机制
妇女保健
上海
北京
management and monitoring mechanism
maternal health
Shanghai
Beijing
