京沪妇女保健体系的薄弱环节分析

Analysis on the Shortcomings of Materaal Health Care in Beijing and Shanghai

目的:明确京沪两地妇保体系的主要薄弱环节,并分析影响其达成国际一流的根源。方法:运用规范差距分析思路,分析京沪妇保工作83个评价指标与国际一流标准的差距,据此确认薄弱环节;遵循卫生系统宏观模型运作规律,明确根源。结果:京沪两地协同支持妇保工作的适宜程度分别为45.1%、36.4%;妇保人员收入水平的适宜程度分别为37.0%、37.6%;常规工作的协调权威程度分别为35.5%、25.5%;各部门职责明确程度分别为23.7%、28.0%,其中支撑部门明确程度均为0%;管理与监控机制可行程度分别为17.8%、19.7%;识别健康风险因素本底状况的程度分别为20.05%和11.82%。结论:“各部门职责不清晰”是根源问题,由此带来了协同支持氛围未形成、资源配置不合理、常规工作协调能力差、管理运行机制不完善等,这是两地妇保体系达成国际一流首先应解决的问题.

Objective To analyze the shortcomings of maternal health care in Beijing and Shanghai,and identify the primary problem that would prevent them from achieving the goal of being top-level.Methods The gap analysis was used to analyze the gap between the status quo and top-level standards of the 83 indicators,which would help to identify the shortcomings.The primary problem was identified based on the principle of the macro model of the healthcare system.Results The degree of cooperative supporting among the whole society for maternal health care in Beijing and Shanghai was 47.5%and 35.0%,respectively.The level of the appropriate income for the staff was 37.0%and 37.6%,respectively.The degree of the coordination authority for routine work was only 35.5%and 25.5%,respectively.The degree of responsibility division among departments was 23.7%and 28.0%,respectively;while those of the supporting departments were all 0%.The degree of the feasibility of the management and monitoring mechanisms was 17.8%and 19.7%,respectively.The degree of identification for health risk factors was respectively 20.05%and 11.82%.Conclusion The unclarity of the responsibility division of the supporting departments was regarded as the root causes,which generated problems such as the lack of cooperative supporting,unreasonable resource allocation,poor regular work coordination,and imperfect operation mechanism.This problem should be resolved in priority so as to help to achieve the goal of being top-level in maternal health care in Beijing and Shanghai.