我国围产儿省际健康公平性研究  

Study on the interprovincial health equity in perinatal infants in China

作　　者：刘诗婷 应晓华[1] LIU Shi-ting;YING Xiao-hua(School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032

出　　处：《中国卫生政策研究》2023年第8期31-39,共9页Chinese Journal of Health Policy

摘　　要：目的:系统分析围产儿健康因素对中国围产儿死亡率省际差距贡献度的变化趋势。方法:使用基尼系数刻画围产儿死亡率省际差异变化特征,基于双向固定效应回归分解影响省际因素的贡献度。结果:2002—2020年围产儿死亡率均值由12.92‰降至4.64‰、基尼系数由0.20降至0.14,其影响因素包括社会经济(城镇人均可支配收入和城镇人口比重)、卫生系统(财政卫生支出、卫生技术人员和妇幼机构数量以及孕产妇系统管理率)以及人口结构(受教育年限),其对省际不公平贡献度分别是63.15%,21.75%和15.10%,其中,卫生系统的贡献程度先下降后上升。结论:围产儿死亡率的省际不公平主要受社会经济因素的影响。相关改革要从财政支出投入和人力资源配置着手,也要对社会经济进行优先考虑。Objective:to systematically analyze the dynamic trend of the contribution of perinatal health factors to the interprovincial gap in perinatal mortality in China.Methods:Gini coefficient is used to characterize the temporal variation characteristics of interprovincial differences in perinatal mortality rate(PMR),and a two-way fixed effect regression is employed to decompose the contribution of the influencing factors of PMR to interprovincial gap.Results:from 2002 to 2020,the average perinatal mortality rate decreased from 12.92‰to 4.64‰;and the provincial Gini coefficient decreased from 0.20 to 0.14.The influencing factors include socio-economic(per capita disposable income of urban populationand the proportion of urban population);health system(financial expenditure on health,the number of health technicians and maternal and child institutions and maternal system management rate),and demographic structure(years of schooling).The contribution of factors to interprovincial inequality is 63.15%,18.44%and 15.10%respectively.The impact of the health system on inequality first decreased and then increased.Conclusion:Interprovincial inequitiesin perinatal mortality are mainly affected by socioeconomic factors.Relevant reform should start with finance,health expenditure input and health human resource allocation,and also give priority to the social economy.

关 键 词：围产儿死亡率 省际 公平性 

分 类 号：R197[医药卫生—卫生事业管理]