广东2000-2016年婚检率变化趋势及婚检服务利用公平性分析
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摘要
目的分析2000—2016年广东省婚检率变化趋势,并对广东省21个地级市婚检服务利用进行公平性分析。方法采用Mann-Kendall法对婚检趋势进行分析,采用集中指数和集中曲线分析广东省21个地级市婚检服务利用公平性。结果 2000—2003年广东省婚检率为50%～70%,2004—2008年为2%～10%,2009—2012年为10%～25%,2013—2016年为25%～50%。21个地市2000—2015年婚检服务利用的集中指数分别为0.18、0.22、0.21、0.26、0.37、0.48、0.53、0.62、0.62、0.55、0.39、0.49、0.39、0.37、0.34、0.21。结论 2000—2016年期间,广东省婚检率骤降后缓慢回升;婚检服务利用一直在社会经济状况高的地级市分布更集中;21个地市婚检服务利用经历着相对公平、相对不公平性变大、相对不公平性变小的趋势;改善婚检服务利用公平性,提高婚检率是关键。
Objective To analyse changing trend of premarital medical examination(PME) rate and the equity of PME service utilization in Guangdong province between 2000 and 2016. Methods Mann-Kendall method was used for trend analysis. Concentration index(CI) and concentration curve were adopted to analyze the equity of PME service utilization.Results In the porovince, the PME rate fluctuated in the range of 50% to 70% during 2000-2003, 2% to 10% during2004-2008, 10% to 25% during 2009-2012, and 25% to 50% during 2013-2016, respectively. The yearly Cl of PME service utilization for the 21 municipalites in Guangdong province was 0.18, 0.22, 0.21, 0.26, 0.37, 0.48, 0.53, 0.62, 0.62,0.55, 0.39, 0.49, 0.39, 0.37, 0.34, and 0.21 for the years from 2000 to 2015. Conclusion The PME rate declined rapidly and then increased slowly in Guangdong province during the period from 2000 to 2016 and the PME service utilization was concentrated in cites with higher socioeconomic development. The PME service utilizaion presented a trajectory from relative equity to increased relative inequity and then to decreased relative inequity in 21 administrative regions during the period. Increasing PME rate is the key to improve the equity of PME service utilization.
Objective To analyse changing trend of premarital medical examination(PME) rate and the equity of PME service utilization in Guangdong province between 2000 and 2016. Methods Mann-Kendall method was used for trend analysis. Concentration index(CI) and concentration curve were adopted to analyze the equity of PME service utilization.Results In the porovince, the PME rate fluctuated in the range of 50% to 70% during 2000-2003, 2% to 10% during2004-2008, 10% to 25% during 2009-2012, and 25% to 50% during 2013-2016, respectively. The yearly Cl of PME service utilization for the 21 municipalites in Guangdong province was 0.18, 0.22, 0.21, 0.26, 0.37, 0.48, 0.53, 0.62, 0.62,0.55, 0.39, 0.49, 0.39, 0.37, 0.34, and 0.21 for the years from 2000 to 2015. Conclusion The PME rate declined rapidly and then increased slowly in Guangdong province during the period from 2000 to 2016 and the PME service utilization was concentrated in cites with higher socioeconomic development. The PME service utilizaion presented a trajectory from relative equity to increased relative inequity and then to decreased relative inequity in 21 administrative regions during the period. Increasing PME rate is the key to improve the equity of PME service utilization.
引文
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[13]郭超,王灏晨,郑晓瑛.从人口出生健康的角度看婚前检查对青年人口的重要性[J].中国妇幼保健,2014,29(9):1313-1315.
[14]陈英,任爱国,叶荣伟,等.婚检政策对妇女婚前、孕前及孕期保健行为影响[J].中国公共卫生,2008,24(6):655-657.doi:10.11847/zgggws2008-24-06-10.
[15]李晓霞.婚检政策对妇女婚前、孕前及孕期保健行为影响[J].当代医学,2009,15(16):45-46.doi:10.3969/j.issn.1009-4393.2009.16.031.
[16]黄蔚,陈英耀,曹建文,等.孕产妇健康与自愿婚前保健政策关系的回顾性研究[J].中国妇幼保健,2006,21(11):1459-1462.
[2]于洋,白符,王冬颖,等.我国婚前医学检查现况与思考[J].中国计划生育学杂志,2017,25(3):151-154.
[3]周玉博,罗树生,李宏田,等.1996年至2013年中国婚前医学检查率变化情况[J].北京大学学报:医学版,2015,47(3):437-442.
[4]马远珠,夏建红,李兵,等.广东省2005—2015年剖宫产率趋势分析及预测[J].中国生育健康杂志,2015,26(6):496-500.doi:10.3969/j.issn.1671-878X.2015.06.002.
[5]Salmi T,Maatta A,Anttila P,et al.Detecting trends of annual values of atmospheric pollutants by the Mann-Kendall test and Sen's solpe estimates the Excel Template Application MAKESENS[J].Universitas Gadjah Mada.2002,31.
[6]张馨予,赵临,夏青,等.运用集中指数评价法对我国省域卫生资源配置的公平性分析[J].中华医院管理杂志,2014,30(1):2-5.doi:10.3760/cma.j.issn.1000-6672.2014.01.001.
[7]World Health Organization.Health inequality monitoring with a special focus on low-and middle-income countries[M].Geneva:World Health Organization,2013.
[8]何利平,李晓梅,孟琼,等.集中指数不同计算方法的比较[J].中国卫生统计,2015,32(4):699-701.
[9]丁雪,王芳,宋莉,等.我国婚前保健服务筹资机制研究[J].中国卫生政策研究,2016,9(5):19-23.
[10]陈永超,王芳,丁雪,等.我国婚检政策执行分析——基于米特——霍恩模型[J].中国卫生政策研究,2016,9(5):24-29.
[11]杜莉,陈英耀.婚前医学检查的作用与意义[J].中国妇幼保健,2006,21(4):448-450.doi:10.3969/j.issn.1001-4411.2006.04.004.
[12]王灏晨,郭超,李宁,等.强制婚检政策取消前后我国出生缺陷发生率变动的meta分析[J].中国计划生育学杂志,2013,21(2):82-87.
[13]郭超,王灏晨,郑晓瑛.从人口出生健康的角度看婚前检查对青年人口的重要性[J].中国妇幼保健,2014,29(9):1313-1315.
[14]陈英,任爱国,叶荣伟,等.婚检政策对妇女婚前、孕前及孕期保健行为影响[J].中国公共卫生,2008,24(6):655-657.doi:10.11847/zgggws2008-24-06-10.
[15]李晓霞.婚检政策对妇女婚前、孕前及孕期保健行为影响[J].当代医学,2009,15(16):45-46.doi:10.3969/j.issn.1009-4393.2009.16.031.
[16]黄蔚,陈英耀,曹建文,等.孕产妇健康与自愿婚前保健政策关系的回顾性研究[J].中国妇幼保健,2006,21(11):1459-1462.