京沪妇女保健物力的质量保证与及时更新

Quality assurance and timely updates of maternal health material resources in Beijing and Shanghai

目的以京沪为例,探讨设施设备质量保证与更新及时对妇女保健(以下简称"妇保")工作支撑作用,并基于文献量化比较差异的可行性.方法收集1995—2017年所有涉及京沪两地妇保资源质量保证与更新及时问题严重程度判断的文献,量化文献有关问题严重程度(0分表示不存在问题,5分表示非常严重).利用Spearman相关分析和回归分析,分析物力的质量保证与及时更新与孕产妇死亡率的关系.结果妇保设施设备质量保证与更新问题严重程度的文献量化评分,2000—2017年京沪两地严重程度都是下降的,分别都由3.50分下降到1.91分、2.05分.两地严重程度评分都与孕产妇死亡率正相关(相关系数北京市为0.492,上海市为0.695).结论京沪两地妇保物力资源质量保证与更新及时适宜程度呈现好转趋势.上海市的物力资源质量保证与更新及时比北京市的质量保证与更新及时对孕产妇死亡率降低的影响更大些,但都存在危房、设备更新不及时等突出问题.适宜的妇保体系应是设施、设备和物资符合标准要求并维护良好,具有折旧更新制度,保障物力提供的可持续性.研究验证了量化妇保物力资源质量保证与更新及时适宜程度的可行性.

Objective To explore the supportive role of facility and equipment quality assurance and timely updates in promoting maternal health,and to explore the feasibility of comparing differences based on literature quantification. Methods Literatures concerning the quality assurance of the maternal health resources in Beijing and Shanghai from 1995 to 2017 were collected. Severity of the problem was rated. The severity of the relevant questions were quantified(0 meaning not a problem,5 points meaning very serious). Spearman correlation analysis and regression analysis were conducted to analyse the relationship between quality assurance and timely updates of material resources and maternal mortality. Results The rated severity of quality assurance and renewal of gynaecological protection equipment decreased from 3.50 points to 1.91 points and 2.05 points,respectively in Beijing and Shanghai from 2000 to 2017. The severity scores of both cities were positively correlated with maternal mortality(the correlation coefficient was 0.492 in Beijing and 0.695 in Shanghai).Conclusion Improvements are shown in the quality assurance and timely updates of maternal health material resources in Beijing and Shanghai. The quality and quantity of Shanghai’s material resources and the degree of timely updates have a greater impact on the maternal mortality than that of Beijing’s,but there are dilapidated buildings and equipment that is not timely updated. It is suggested that the suitable material resources for maternal health care system ensure facilities, equipment and materials to meet the standard requirements and wel-maintained,and depreciation and renewal system be established to ensure the sustainability of material resources. The feasibility of quantifying timely updates and quality assurance of maternal health material resources is verified.