京沪妇幼保健领域政府投入明确程度分析

Analyzing the Degree of Clarity of Governmental Input on Maternal and Child Health Care in Beijing and Shanghai

目的:以政策文本分析视角,通过量化政府投入明确程度,探讨政府投入明确程度对妇女健康结果的影响。方法:系统收集1991~2017年所有涉及京沪两地妇幼工作公开相关政策文件,量化投入政策的明确程度,运用Spearman相关、线性回归分析政府投入明确程度与孕产妇死亡率之间的关系。结果:1991~2017年,两地妇幼保健投入明确程度从0.0%上升到83.3%;2017年两地对投入的总量已明确界定,但投入增长幅度还需进一步明确(66.7%);两地的孕产妇死亡率与投入明确程度之间呈现负相关(P<0.01),北京投入明确程度对孕产妇死亡率变化的解释程度为40.4%,上海为61.5%,京沪两地政府投入明确程度均对健康结果产生显著影响。结论:京沪两地妇幼领域经费投入的明确程度较为适宜,投入明确程度的作用初步体现。北京经费投入明确程度的引领作用比上海弱;两地尚需明确经费投入增长机制。

Objective To explore the influence of the degree of clarity of governmental input on maternal and child health by quantifying it from the perspective of policy document analysis. Methods The public policy documents on maternal and child health care in Beijing and Shanghai from 1991 to 2017 were collected. The relationship between the degree of clarity and maternal mortality was analyzed with Spearman correlation and linear regression method. Results The degree of clarity of governmental input increased from 0. 0% to 83. 3% from 1991 to 2017. In 2017,the total amount of input in these two cities had been clearly defined,while its growth rate needed to be further clarified. There had significantly negative correlation between the maternal mortality and the degree of clarity in these two cities P<0. 01). The explanation rate of clarity of governmental input on the maternal mortality was 40. 4% in Beijing,which was 61. 5% in Shanghai. The degree of clarity of governmental input in Beijing and Shanghai had significant influence on health outcomes. Conclusion The degree of clarity of governmental input on maternal and child health care in Beijing and Shanghai is appropriate,which has preliminarily reflected its guidance and needs to be further improved.