外来孕产妇平产政策的系统思考  

Systematic Thinking on the Fixed-hospital Delivery Policy for Pregnant Women in the Floating Population

作　　者：陆璇 谢岳林 蔡雨阳[2,3] Wheat ID 

机构地区：[1]上海市嘉定区卫生局,上海201800 [2]上海交通大学公共卫生学院,上海200025 [3]卑尔根大学系统动力学研究中心

出　　处：《中国社会医学杂志》2013年第6期376-378,共3页Chinese Journal of Social Medicine

基　　金：上海市卫生局科研课题(2009223);美国中华医学基金会青年基金(Seed Grant 2011)

摘　　要：目的系统评价上海市嘉定区平产政策执行的情景、问题和因果关系,寻找政策失灵的解决之道。方法采用系统动力学因果流图进行系统思考,探讨平产政策作用于外来孕产妇和平产点医务人员的系统关系。结果外来孕产妇数量的急剧上升,造成平产点负担加重,平产限价和政府补偿不足是系统中两个重要的杠杆量。结论增加政府对平产点的补偿,适度升高平产政策的限价门槛,并在中长期建立信息共享机制与平台,提高外来人口管理水平和社会保障能力。Objectives To examine the status, problems and causality of the Fixed-hospital Delivery Policy in Jiading district, and to explore the solution of the policy failure inside the health system. Methods Applying the thinking ways of causal flow diagram of system dynamics to explore the systematic relationship of Fixed-hospital Delivery Policy with the floating pregnant women and the health workers. Results Two leverage variables were found in this health system, which caused the dramatic increase of the floating pregnant women, and brought heavy burden on the health workers in the fixed hospitals. One leverage variable was the limited price regulated by the policy; another was the lack of government compensation for these fixed hospitals. Conclusions The government compensation for these fixed hospitals should be increased; the limited price should be elevated; the information sharing and reporting system should be established, and then the social security level for the floating population should be improved.

关 键 词：平产政策 外来孕产妇 系统思考 政策失灵 

分 类 号：R715.3[医药卫生—妇产科学]