目标设置科学合理对京沪妇女保健工作效果的影响
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摘要
目的比较京沪两地政府在妇女保健工作中设置目标科学合理程度的差异,分析原因并论证其意义。方法收集京沪两地妇女保健相关政策文件、法律规制等,根据文件中敏感指标的纳入情况、敏感指标是否定量、可考核、有依据,计算目标设置科学合理程度。运用相关、回归方法分析目标设置科学合理程度与孕产妇死亡率之间的关系。结果截止到2017年,北京市妇女保健领域目标设置科学合理程度为75. 01%,上海市目标设置科学合理程度达到91. 88%;北京地区妇女保健领域目标设置科学合理程度与当地孕产妇死亡率之间呈负相关(r_(北京)=-0. 630)。结论适宜的妇女保健体系应因地制宜地设置目标并充分体现努力方向和先进性;京沪两地妇女保健领域目标设置科学合理程度均显著增加,且该指标对孕产妇死亡率有一定影响,验证了指标的量化具有可行性。
Objective To compare the differences in the scientific and reasonable degrees of the goals setting on maternal health by the governments of Beijing and Shanghai,to analyze the reasons,and to test the reliability and feasibility of the indicator. Methods The research materials of policies and laws on maternal health care of Beijing and Shanghai were collected. The scientific and reasonable degree of goals setting was calculated according to the inclusion of sensitive indicators and whether the sensitive indicators were quantitative,evaluable and valid.Spearman correlation and linear regression were used to analyze the relationship between the scientific and reasonable degree of goals setting and maternal mortality rate( MMR). Results By 2017,the scientific and reasonable degree of the goals setting of Beijing was 75. 01%,and the scientific and reasonable degree of the goals setting of Shanghai was 91. 88%. There was a negative correlation between the indicator and MMR in Beijing( r_(Beijing)=-0. 630). Conclusions Appropriate maternal health system should set scientific and reasonable goals according to local conditions. The scientific and reasonable degree of the goals setting has been increased both in Beijing and Shanghai. This indicator affects MMR to a degree,which can be applied to assess the health outcomes of maternal health system.
Objective To compare the differences in the scientific and reasonable degrees of the goals setting on maternal health by the governments of Beijing and Shanghai,to analyze the reasons,and to test the reliability and feasibility of the indicator. Methods The research materials of policies and laws on maternal health care of Beijing and Shanghai were collected. The scientific and reasonable degree of goals setting was calculated according to the inclusion of sensitive indicators and whether the sensitive indicators were quantitative,evaluable and valid.Spearman correlation and linear regression were used to analyze the relationship between the scientific and reasonable degree of goals setting and maternal mortality rate( MMR). Results By 2017,the scientific and reasonable degree of the goals setting of Beijing was 75. 01%,and the scientific and reasonable degree of the goals setting of Shanghai was 91. 88%. There was a negative correlation between the indicator and MMR in Beijing( r_(Beijing)=-0. 630). Conclusions Appropriate maternal health system should set scientific and reasonable goals according to local conditions. The scientific and reasonable degree of the goals setting has been increased both in Beijing and Shanghai. This indicator affects MMR to a degree,which can be applied to assess the health outcomes of maternal health system.
引文
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[2]Guo J,Tang Y,Wiley J,et al.Effectiveness of a diabetes prevention program for rural women with prior gestational diabetes mellitus:study protocol of a multisite randomized clinical trial[J].BMC Public Health,2018,18(1):809.
[3]郝模,李程跃,于明珠,等.新时代公共卫生体系的思考与研究[J].上海预防医学,2017(12):905-910.
[4]付非,郑锴,翁苏湘.中低收入国家私营和公共卫生系统治疗效果与监管分析[J].中国农村卫生事业管理,2018,38(1):4-6.
[5]纪颖,张炎,韩俊魁.基于母婴保健的政府主导下公共卫生领域非政府组织发展策略分析[J].医学与社会,2011(4):46-49.
[6]张石磊.目标设置理论的实验研究[D].西安:西北大学,2010.
[7]张美兰,车宏生.目标设置理论及其新进展[J].心理学动态,1999(2):35-40.
[8]魏四新,郭立宏.我国地方政府绩效目标设置的研究---基于目标设置理论视角[J].中国软科学,2011(2):8-15.
[9]郝模,马安宁,王志锋,等.卫生政策学[M].北京:人民卫生出版社,2013.
[10]Ellencweig AY.Analysing health systems:a modular approach[M].Oxford University Press,1992.
[11]刘苗苗,于芳,郑文贵,等.京沪政府关注妇女保健问题范围比较[J].中国农村卫生事业管理,2019,39(2):119-123,138.
[12]Zhang Y,Wang L,Yin C,et al.Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management:a retrospective study based on hospital routine data[J].BMJ Open,2018,8(6):e019645.
[13]Du Y,Lin J,Lan L,et al.Detection of chromosome abnormalities using current noninvasive prenatal testing:A multi-center comparative study[J].Biosci Trends,2018(3):317-324.
[14]杨发祥.当代中国计划生育史研究[D].杭州:浙江大学,2004.
[15]课题组.《上海现代化国际大都市公共卫生绩效体系构建》结题报告[R].2018.