京沪妇幼保健领域政府筹资机制健全程度分析

Analyzing the Perfectness Degree of Governmental Financing Mechanism of Maternal and Child Health Care in Beijing and Shanghai

目的:探讨并量化妇幼保健领域政府筹资机制健全程度,分析其与孕产妇死亡率的相关性,检验基于政策文本的健全程度评价妇幼保健工作效果的可行性。方法:系统收集2000~2017京沪两地妇幼工作公开相关政策文件,通过“政府投入明确程度”、“政府主导筹资职责明确程度”、“政府投入可落实程度”综合量化分析政府筹资机制健全程度,运用线性回归分析健全程度与孕产妇死亡率之间的关系。结果:2000~2017年,两地政府筹资机制健全程度从0.00%上升到73.35%;其中,2017年两地投入明确程度(83.3%),政府主导筹资职责明确程度(66.67%),政府投入可落实程度(66.67%);两地的孕产妇死亡率与健全程度呈负相关(P<0.01),北京政府筹资机制健全程度对孕产妇死亡率影响的解释程度为25.2%,上海没有显著性影响。结论:京沪妇幼工作中筹资机制的逐步健全使京沪妇幼工作得到了良好的保障;政府筹资机制的健全对北京妇幼工作的保障程度不如上海;京沪妇幼工作的筹资机制还有待进一步健全。

Objective To quantify the perfectness degree of governmental financing mechanism of maternal and child health care, analyze its correlation with maternal mortality, and test the feasibility of evaluating the effect of maternal and child health care from the perspective of policy documents. Methods The public policy documents on maternal and child care in Beijing and Shanghai from 2000 to 2017 were collected. The perfectness degree of governmental financing mechanism was quantified synthetically by analyzing the degree of clarity of government investment, degree of clarity of government-leading financing responsibilities, degree of implementation of government investment. The relationship between the perfectness degree and maternal mortality was analyzed with linear regression. Results The perfectness degree of governmental financing mechanism in these two cities increased from 0.00% to 73.35% from 2000 to 2017. In 2017, the degree of clarity of investment was 83.3%, the degree of clarity of government-leading financing responsibilities was 66.67%, and the degree of implementation of government investment was 66.67%. There had significantly negative correlation between the perfectness degree and maternal mortality in these two cities(P<0.01). The explanation degree of the influence of perfectness of governmental financing mechanism on maternal mortality was 25.2% in Beijing, while no significantly negative correlation was observed in Shanghai. Conclusion The perfectness of financing mechanism of maternal and child care in these two cities has guaranteed the maternal and child care, which was better in Shanghai, and needs to be further improved.