我国市(地)级妇幼保健机构大部制改革效果分析  

Analysis of the effect of government department system reform in maternal and child health institutions at municipal level in China

作　　者：孙昂 罗荣[1] 胡文玲[1] 黄爱群[1] SUN Ang;LUO Rong;HU Wen-ling;HUANG Ai-qun(Maternal and Child Health Center of China CDC,Beijing 100081,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

出　　处：《卫生软科学》2021年第2期6-11,共6页Soft Science of Health

摘　　要：[目的]了解我国市(地)级妇幼保健机构大部制改革的效果,为其它妇幼保健机构的改革提供参考。[方法]通过全国妇幼保健机构监测网络直报系统,收集2018年全国市(地)级妇幼保健机构的相关信息,运用倾向性评分匹配法确定改革组与未改革组,通过卡方检验与秩和检验进行组间比较。[结果]全国市(地)级妇幼保健机构进行大部制改革的比例为29.02%。匹配前改革组机构的资源配置等基础指标均高于未改革组机构,差异均有统计学意义(P <0.01)。因此以地区、机构性质、机构等级评审级别、实有床位数4个指标为协变量进行倾向性评分匹配,匹配后两组机构资源配置等基本指标的差异无统计学意义(P> 0.05),改革组机构和未改革组机构具有可比性。匹配后改革组机构的平均住院日低于未改革组机构,改革组机构年门诊人次数、本年度共为基层举办各类妇幼保健业务技术培训班期次、培训基层卫生技术人员数、因群体妇幼保健工作下基层人·天数、接受基层进修人员数(一个月以上)均高于未改革组机构,差异均有统计学意义(P <0.05)。[结论]我国进行大部制改革的市(地)级妇幼保健机构比例较低,大部制改革效果逐渐显现,但仍有待进一步推进。Objective To understand the effect of government department system reform in maternal and child health institutions at municipal level in China so as to provide reference for the reform of other maternal and child health institutions. Methods Through the monitoring network direct report system of the national maternal and child health institutions, the relevant information of maternal and child health institutions at municipal level in 2018 were collected. This paper used propensity score matching method to determine reform group and control group, and compared the groups through chi square test and rank sum test. Results The proportion of maternal and child health institutions at municipal level which carried out government department system reform was 29.02%. The basic indexes of resource allocation in the reform group were higher than those in the control group before propensity score matching, there was statistical significance in difference(P < 0.01). Therefore, 4 indexes of region, nature of organization, grade review level and number of actual beds as covariates were conducted propensity score matching, there was not statistically significant in difference of basic indexes of resource allocation in two groups after the matching(P > 0.05), both reform group and control group had comparability. The average length of stay in reform group was lower than that in control group, while annual number of outpatients, training classes on maternal and child health care technology held for grass-roots, number of health technician trained for grass-roots, the sum days of staff who went to grass-roots organizations for community maternal and child health care, number of advanced personnel accepted from grass-roots organizations(more than one month) in reform group were higher than those in control group, there were statistically significance in differences(P < 0.05). Conclusions The proportion of maternal and child health institutions at municipal level which carry out government department reform is relatively low, and

关 键 词：妇幼保健机构 大部制改革 保健和临床融合 群体保健 倾向性评分匹配 

分 类 号：R172[医药卫生—妇幼卫生保健]