初级卫生保健试点县妇幼保健投入产出分析

  目的  分析2000 — 2017年京沪妇女保健财力资源适宜程度及孕产妇死亡率的变化趋势，明确2地差异，探讨妇女保健财力资源适宜程度。  方法  收集1995 — 2017年涉及京沪妇女保健财力投入政府主导问题（202篇）、投入总量问题（205篇）和投入增长问题（122篇）文献，综合投入政府主导适宜程度、投入总量适宜程度、增长适宜程度等3个指标，计算财力资源的适宜程度。运用Spearman相关、线性回归等分析妇女保健财力资源适宜程度与孕产妇死亡率的关系。  结果  北京妇女保健财力资源适宜程度从2000年的28.40 %升至2017年的42.60 %，上海则由22.60 %升至69.40 %，北京和上海的回归方程均有统计学意义（上海P < 0.01，北京P < 0.05）。  结论  京沪2地妇女保健财力资源适宜程度逐年提高，上海财力资源在孕产妇死亡率下降中作用更大，但财力投入稳定增长仍是薄弱环节；适宜的妇女保健体系应“政府负责、投入适宜、稳定增长”；验证了量化妇女保健财力资源适宜程度的可行性。

Suitability of financial investment for maternal health care in Beijing and Shanghai: a literature analysis

  Objective  To analyze the suitability of financial investment for maternal health care (MHC) and changing trend of maternal mortality ratio (MMR) and their regional disparities in Beijing and Shanghai municipality during the period from 2000 through 2017.  Methods  We retrieved research articles on government predominance in financial investment (n = 202), total financial investment (n = 205) and increment in the financial investment (n = 122) for MHC in Beijing and Shanghai municipality from 1995 to 2017 and assessed the suitability of these investments. Spearman correlation and linear regression analysis were used to analyze the relationship between the financial investment suitability and MMR.  Results  The indicator for the suitability of financial investment for MHC increased from 28.40% and 22.60% in 2000 to 42.60% and 69.40% in 2017 in Beijing and Shanghai municipality. The regression analyses resulted in a significant correlation between the financial investment suitability and MMR in Shanghai (P < 0.01) and Beijing (P < 0.05).  Conclusion  The suitability of financial investment for maternal health care was increased in Beijing and Shanghai but still needs to be improved. The study demonstrates the feasibility of quantitatively evaluating the suitability of financial investment for maternal health care.