妇幼计生资源整合对市县级妇幼保健机构发展的影响  

Research on the influence of integration of service resources of maternal and child health care and family planning on the development of maternal and child health care institutions at city and county level

作　　者：胡文玲[1] 罗荣[1] 白晶 HU Wen-ling;LUO Rong;Bai Jing(National Center for Women and Children s Health,China CDC,Beijing 100081,China;National Institute for Nutrition and Health,China CDC,Beijing 100050,China)

机构地区：[1]中国疾病预防控制中心妇幼保健中心,北京100081 [2]中国疾病预防控制中心营养与健康所,北京100050

出　　处：《卫生软科学》2020年第6期82-85,96,共5页Soft Science of Health

基　　金：国家卫生健康委员会妇幼司委托课题:县级以上妇幼保健计划生育资源整合总结研究。

摘　　要：[目的]探索和分析妇幼保健与计划生育技术服务资源整合对市县级妇幼保健服务体系的影响。[方法]采用年度机构监测信息系统和典型地区调查相结合的方法,选择2013年和2016年全国地市级和县区级机构监测数据,同时在全国范围内选择7个省14所完成妇幼保健和计划生育资源整合的市县级妇幼健康服务机构开展典型地区调查。[结果]与2013年比较,2016年已整合的妇幼保健机构人、财、物等资源指标、医疗保健服务提供指标、计划生育技术服务项目的开展比例均呈现明显增长,且明显高于未整合机构;倍差法分析发现,实施整合政策影响使得各项指标呈现明显增长,经回归分析,除出院人次和手术人次外,差异无统计学意义;由于国家生育政策调整,放置宫内节育器及皮下埋置避孕剂、实施输卵管和输精管结扎术、人工流产和药物流产的例数明显下降,取出宫内节育器、实施输卵管和输精管吻合术的例数明显增加。[结论]妇幼计生资源整合初见成效,但整合与妇幼保健机构发展之间的关联强度较弱;计划生育技术服务工作重点发生转变;计划生育技术服务在融入妇幼保健服务中得到加强。Objective To explore and analyze the influence of the integration of service resources of maternal and child health care and family planning on the maternal and child health care institutions at city and county level.Methods It adopted the method of year institution monitoring information system combined with type area investigation,selected institution monitoring data of nationwide at prefecture(city)and county(district)level in 2013 and 2016,and typical area survey was conducted among 14 municipal and county-level maternal and child health service institutions in 7 provinces of nationwide that have completed the integration of service resources of maternal and child health care and family planning at the same time.Results Compared with 2013,in 2016,the proportion of integrated maternal and child health care institutions in terms of human,financial and material resources,medical and health care service delivery indicators,and family planning technical service projects were significantly increased,which was significantly higher than that of unintegrated institutions.Difference-in-differences analysis method found that the influence of implementation of integrated policies resulted in an obvious increase in all indicators.Through regression analysis,the difference had not statistically significant except for discharge and operation in person-time.Due to the adjustment of the national fertility policy,the number of cases of intrauterine device(IUD)placement and subcutaneous implantation of contraceptives,tubal and vas deferens ligation,induced abortion and medical abortion decreased significantly,while the number of cases of IUD removal and oviduct and vas deferens anastomosis increased significantly.Conclusions The integration of service resources of maternal and child health care and family planning has achieved initial results,but the correlation intension in development among maternal and child health institutions is weak.Key emphasis work of technical services for family planning has been changed.Family planni

关 键 词：妇幼保健 计划生育 资源整合 倍差法 服务体系 影响研究 

分 类 号：R172[医药卫生—妇幼卫生保健] R169[医药卫生—公共卫生与预防医学]