京沪妇女保健人员规模适宜程度比较

Suitability of maternal health care staff quantity in Beijing and Shanghai: a comparison analysis

目的分析2000—2017年京沪妇女保健人员数量不足严重程度及孕产妇死亡率的变化趋势,明确两地差异,探讨妇女保健人员规模适宜程度。方法收集1995—2017年涉及京沪妇女保健资源问题的文献,系统筛选所有妇女保健人员规模主题的相关文献(北京纳入79篇,上海纳入87篇),摘录人力数量不足问题的相关表述,计算妇女保健人员数量不足严重程度评分。运用Spearman相关、线性回归等分析妇女保健人员数量不足严重程度与孕产妇死亡率的关系。结果北京妇女保健人员数量不足严重程度从2000年的3.76分降至2017年的3.40分,上海则由4.00分降至2.10分。上海孕产妇死亡率与妇女保健人员数量不足严重程度相关有统计学意义(r=0.756,P<0.01)。上海的回归方程有统计学意义(P<0.01)。结论京沪两地妇女保健人员规模适宜程度逐步提高,上海妇女保健人员规模在孕产妇死亡率降低中作用更大,但人员结构存在问题;适宜的妇女保健体系应"人员数量满足工作开展需要";验证了量化妇女保健人力规模的可行性。

Objective To analyze the extent of deficit in total quantity of maternal health care(MHC) staff, the changing trend of maternal mortality rate(MMR) and their regional disparities in Beijing and Shanghai municipality during the period from 2000 through 2017 and to explore the suitable scale of MHC staff for the two regions. Methods We searched China National Knowledge Infrastructure(CNKI) and Web of Science for research literatures on human resource for MHC in Beijing and Shanghai municipality from 1995 to 2017. The information on the deficit in total quantity of MHC staff was extracted from 166 retrieved studies(79 in Beijing and 87 in Shanghai) for calculation of a severity score to evaluate the deficit. Spearman correlation and linear regression analysis were used to analyze the relationship between the deficit in total quantity of MHC staff and MMR. Results For Beijing municipality, the severity score for the deficit in total quantity of MHC staff decreased from 3.76 in 2000 to 3.40 in 2017, while for Shanghai municipality, the score decreased from 4.00 to2.10. A significant correlation between MMR and the severity score was detected for Shanghai(r = 0.756, P < 0.01).Conclusion The suitability of maternal health care staff quantity increased gradually in both Beijing and Shanghai municipality during 2000 - 2017 and the impact of the increase in total quantity of the staff on maternal mortality rate is more obvious for Shanghai. The study verified the feasibility of quantitative assessment on the scale of maternal health care staff.