摘要
目的:分析京沪两地妇女保健工作管理与监控机制可行程度的变迁,阐明适宜可行程度的重要意义并验证其量化方法。方法:系统收集京沪两地所有涉及妇保工作的政策文献,在对"管理与监控机制覆盖部门""部门职责清晰可考核"和"部门职责清晰可考且有考核主体"进行分析的基础上综合量化形成可行程度,运用Spearman相关、线性回归等分析可行程度与孕产妇死亡率之间的关系。结果:两地妇保领域管理与监控机制可行程度提升明显,上海由2.20%提升至19.67%,北京由1.80%提升至17.76%,但关键支撑部门的职责不清且无法落实。两地的可行程度与孕产妇死亡率均呈负相关,并对其有显著影响(上海r^2=0.354,P=0.005,北京r^2=0.309,P=0.010)。结论:适宜的妇保体系需确保管理与监控机制能够有效落实、严格约束各方行为;上海市妇保领域管控机制可行程度提高的程度略优于北京市,但两地总体仍处于较低水平,人力等关键支撑部门职责仍较为不清;分析结果表明对可行程度的量化方法科学可行。
Objective To analyze the changes in the feasibility degree of management and monitoring mechanisms of maternal health care in Beijing and Shanghai,and clarify the importance of appropriateness and feasibility and to verify the quantitative methods of feasibility. Methods Systematic collect all policy documents related to maternal work in Beijing and Shanghai. On the basis of the analysis of"management and monitoring mechanism cover departments","departments’ responsibilities are clear and assessable"and"departments’ responsibilities are clear and have examination subject",we use synthetically quantifying to obtain the feasibility degree. Spearman correlation and linear regression were used to analyze the relationship between the feasibility degree and maternal mortality. Results The feasibility of management and monitoring mechanisms in the area of maternal health care in Beijing and Shanghai has increased significantly( Shanghai increased from 2. 20% to 19. 67%,Beijing increased from 1. 80%to 7. 76%),but the responsibilities of the key support departments are unclear and cannot be implemented. In particular,the responsibilities of the external strong support department of the health system are unclear and cannot be implemented. The feasibility degree has a significant negative correlation with maternal mortality between the two places( Shanghai r^2= 0. 354,P = 0. 005,Beijing r^2= 0. 309,P = 0. 010). Conclusion Appropriate maternity insurance system needs to ensure that the management and monitoring mechanism can effectively implement and strictly restrict the behavior of all parties,the feasibility of improving the control mechanism in Shanghai is slightly better than Beijing,but the overall level is still at a low level and support department responsibilities are still relatively unclear. This study is scientific and feasible for the quantitative method of feasibility degree.
作者
陈任
李程跃
李力
陈菲
蒲川
徐凌忠
沈群红
于明珠
郝超
郝模
胡志
CHEN Ren(School of Health Service Administration,Anhui Medical University,Hefei,P. R. China)
出处
《中国卫生事业管理》
北大核心
2019年第5期390-392,396,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)
安徽高校智库项目"安徽省健康发展战略研究中心"(皖教工委函[2015]271号)
关键词
妇女保健
管理与监控机制
可行
北京
上海
maternal health care
management and monitoring mechanism
feasible
Beijing
Shanghai
