京沪社会经济状况对妇保关键目标的支撑作用

The support for key objectives of maternal healthcare services provided by social economy in Shanghai and Beijing

目的分析京沪两地社会经济对妇女保健工作的支撑程度。方法收集京沪两地2000-2016年人均GDP、人均卫生总费用、人均政府卫生支出、人均公共卫生机构费用等指标,运用Spearman相关分析上述社会经济指标、卫生领域投入指标与孕产妇死亡率之间相关关系。结果 2016年北京、上海人均GDP分别比2001年增长164. 02%、180. 59%,人均财政支出分别比2001年增长339. 76%、412. 28%;随着两市经济的快速发展,对公共卫生领域的投入也逐步增长,人均公共卫生机构费用分别增长了179. 96%和134. 60%,但增长幅度低于人均财政支出。相关分析结果显示:上海的人均GDP、人均公共卫生机构费用与孕产妇死亡率之间存在显著负相关,而北京人均公共卫生机构投入与孕产妇死亡率之间未呈现显著相关关系。结论适宜的妇女保健体系中,社会经济基础应能支撑体系的运转;京沪两地社会经济发展对降低孕产妇死亡率有一定贡献,其中上海的支撑程度更明显;但两地仍存在公共卫生投入缺乏制度保障,具有随意性的情况。

Objective To analyze the support for maternal healthcare services provided by social economy in Shanghai and Beijing.Methods Indicators were collected including GDP per capita,total health cost per capita,government health expenditure per capita and public health institution cost per capita in Beijing and Shanghai during 2000-2016.Spearman correlation analysis was employed to analyze the relationship between the indicators of social economy as well as health investment and maternal mortality rate(MMR).Results The GDP per capita of Beijing and Shanghai in 2016 increased by 164.02%and 180.59%respectively compared with those in 2001,and the public finance expenditure per capita of Beijing and Shanghai in 2016 increased by 339.76%and412.28%respectively compared with those in 2001.With the rapid economic development of Beijing and Shanghai,the investment in the field of public health also gradually increased,and the public health institutions cost per capita increased by 179.96%and 134.60%respectively,but the growth was lower than the per capita fiscal expenditure.The results of correlation analysis showed that there was a significantly negative correlation between Shanghai’s average GDP,the public health institution cost per capita and MMR,while there was no significant correlation between the public health institutions cost per capita in Beijing and MMR.Conclusions In an appropriate MCH system,the social economic base should be able to support the operation of the system.The social and economic development of Beijing and Shanghai has made certain contribution to reducing MMR,in which the support degree of Shanghai is more obvious,but there is still a lack of system guarantee for public health investment in both cities,which is arbitrary to some degree.