“单独两孩”政策对上海市医疗卫生行业的影响研究

Influence Research of Two-child Policy on Healthcare Industry in Shanghai

目的了解"单独两孩"政策的出台对上海市医疗卫生行业的影响,并由此提出有关对策建议。方法通过宏观层面分析、焦点组访谈、问卷调研等多形式的调查手段,综合分析评估"单独两孩"政策实施后对上海市医疗卫生系统的需求和影响。结果 "单独两孩"政策实施对上海市医疗卫生行业的分别产生了3大影响和挑战。(1)影响:未来几年上海市将增加至少10%的年分娩量,2016年可能面临一个生育小波峰;妊娠风险增加,高风险、高技术含量的产科任务增加;儿科医疗服务量的增加将逐渐出现,呈叠加之势。(2)挑战:政策调整将加剧产科医疗资源使用的不均衡,首要受到冲击的是优质产科机构;妊娠风险增加将进一步考验上海高危产科的整体应对能力;出生人口的增加和不断叠加将使本已短缺的儿科医疗资源雪上加霜。结论 "单独两孩"政策的影响辐射结果提示了政府主导辅以市场机制调控的重要性和迫切性;需要尽快扭转孕妇自由选择分娩医院的无序状态,保证优质产科资源真正为高危孕产妇服务;整合区域内不同层次产儿科医疗资源,以提高对高危产科的整体应对水平。

Objective To explore the impact of two-child policy on healthcare industry in Shanghai and to provide corresponding strategies and suggestions. Methods Multiforms of investigations including macro-level analysis,focus group discussions, questionnaires and on-the-spot visits were conducted in order to assess the influence and requirements that the new policy had posed on Shanghai medical health care service. Results Three main impacts and challenges respectively are caused by the two-child policy.（1） Impacts：The annual newborn numbers will increase at least 10% in Shanghai in the next few years; and there could be a small birth peak in 2016. Pregnancy risks and high-tech-and-risk obstetrical tasks will rise accordingly. The pediatric health care service number will emerge gradually.（2） Challenges：This policy adjustment will aggravate the unequivalent use of obstetrical resources,especially in the field of obstetrical health institutions of high quality. The entire coping capability of high risk obstetrics will be challenged by the rising pregnancy risks. The increasing birth numbers will exacerbate the scarce pediatric resources.Conclusion The impacts of the new two-child policy reveals the importance and urgency of government-led and market-regulated mechanisms. The disorders that pregnant women can choose any hospital to give birth should be reversed as soon as possible so that the high-risk women can be completely covered by the high quality obstetric institutions. In addition,different levles of obstetric and pediatric resources in one area need to be integrated to improve the capacity of high risk obstetrics.