京沪妇女保健服务的公平性简析：基于文献分析视角  

Analysis of the equity of maternal health services in Beijing and Shanghai based on perspective of literature analysis

作　　者：左姣 王旭 于明珠 徐天强 郝超[4,10] 陈政 沈群红[6,10] 徐凌忠 蒲川[8,10] 胡志 郝模[1,10] 李程跃 ZUO Jiao;WANG Xu;YU Ming-zhu;XU Tian-qiang;HAO Chao;CHEN Zheng;SHEN Qunhong;XU Ling-zhong;PU Chuan;HU Zhi;HAO Mo;LI Cheng-yue(Research Institute of Health Development Strategies,Fudan University,Shanghai 200032,China;Collaborative Innovation Center of Social Risks Governance in Health,Shanghai 200032,China;Disease Control and Prevention Branch of China Association of Health Promotion and Education,Shanghai 201821,China;Institute of Inspection and Supervision,Shanghai Municipal Commission of Health and Family Planning,Shanghai 200031,China;Changzhou Center for Disease Control and Prevention,Changzhou 213003,Jiangsu China;Department of Grassroots Public Health Management Group,Public Health Management Branch of Chinese Preventive Medicine Association,Shanghai 201800,China;School of Public Policy and Management,Tsinghua University,Beijing 100084,China;School of Public Health,Shandong University,Jinan 250012,Shandong China;School of Public Health and Management,Chongqing Medical University,Chongqing 400016,China;School of Health Service Administration,Anhui Medical University,Hefei 230032,Anhui China)

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [10]健康相关重大社会风险预警协同创新中心,上海200032 [2]中国健康促进与教育协会疾病预防控制分会,上海201821 [3]上海市卫生和计划生育委员会监督所,上海200031 [4]常州市疾病预防控制中心,常州213003 [5]中华预防医学会公共卫生管理分会基层公共卫生管理学组,上海201800 [6]清华大学公共管理学院,北京100084 [7]山东大学公共卫生学院,济南250012 [8]重庆医科大学公共卫生与管理学院,重庆400016 [9]安徽医科大学卫生管理学院,合肥230032

出　　处：《中国卫生资源》2019年第1期1-5,共5页Chinese Health Resources

基　　金：国家自然科学基金项目(71774031,71303058);国家“十二五”科技支撑子项目(2014BAI08B01);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(GWIV-32);健康相关重大社会风险预警协同创新中心科研基金

摘　　要：目的基于文献视角,分析京沪两地妇女保健(以下简称“妇保”)服务提供不公平性的严重程度及其差异,探索提升服务公平性的重要意义以及定量评价服务公平性的可行性。方法系统收集1995—2017年所有涉及北京、上海两地妇保服务公平性问题的文献,采用“五分度评分法”半定量评判服务提供不公平性的严重程度。运用Spearman相关分析和线性回归分析分析服务提供不公平性的严重程度评分与孕产妇死亡率的关系。结果京沪两地妇保服务提供不公平性的严重程度均呈下降趋势,北京市从2000年的4.00分下降至2017年的2.60分,上海市从2000年的4.00分下降至2017年的2.71分。两地的妇保服务不公平性严重程度与孕产妇死亡率之间均呈正相关,相关系数分别为0.515和0.715。结论京沪两地妇女保健服务公平性得到改善,上海市服务公平性改善的作用优于北京市,但两地仍有提升空间。适宜的妇保体系应确保城乡、不同族群、不同区域、不同收入人群获得服务的公平性。同时,验证了基于文献分析评价妇保服务公平性具有可行性。Objective To analyze the severity and differences of maternal health service inequity in Beijing and Shanghai,and to explore the significance of improving service equity and the feasibility of quantitative evaluation on service equity based on literature analysis.Methods All literature concerning the equity of maternal health services in Beijing and Shanghai from 1995 to 2017 were collected systematically,and the “five-point scale method” was used to semi-quantitatively evaluate the equity of services.Spearman correlation and linear regression were used to analyze the relationship between the score and maternal mortality.Results The severity of the inequity of maternal health services in Beijing and Shanghai showed a downward trend.Beijing dropped from 4.00 points to 2.60 points between 2000 and 2017;Shanghai also fell from 4.00 points to 2.71 points between 2000 and 2017.There was a negative correlation between the severity of inequity and maternal mortality in Beijing and Shanghai,with correlation coefficients of 0.515 and 0.715,respectively.Conclusion The equity of maternal health services in Beijing and Shanghai has been improved,and the impact of Shanghai’s service equity improvement is better than that of Beijing,but there is still room for improvement.The appropriate services for the maternal health care system should be equitable and accessible,ensuring fair access to services for urban and rural residents,different ethnic,regions,and income groups.The results also indicated that literature analysis was feasible as a tool to evaluate the equity of maternal health services.

关 键 词：妇女保健 服务提供 公平性 严重程度评分 孕产妇死亡率 Spearman相关分析 线性回归分析 

分 类 号：R173[医药卫生—妇幼卫生保健] R19[医药卫生—公共卫生与预防医学]