“新生儿安全项目地区”经济发展及卫生投入对妇幼健康的影响

  目的  了解中国不同级别、不同类型妇幼保健机构收入状况，为制定适宜的投入保障政策和进一步深化医药卫生体制改革提供依据。  方法   通过全国妇幼保健机构监测直报系统，收集并比较2020年中国所有妇幼保健机构共3 094家资金收入状况，同时运用2020中国卫生健康统计年鉴，分析比较不同公共卫生机构的财政补助收入状况。  结果  2020年中国妇幼保健机构财政补助（630.9亿元）占总收入的28.7 %，远远低于同为公益一类机构的疾病预防控制中心（73.6 %）和卫生监督所（中心）（91.5 %）的财政占比。不同地区、不同级别、不同机构性质保健院均收入存在明显差异，东部地区（2 581.0万元）、省级（71 217.0万元）、公益一类二类并存（7 033.5万元）的妇幼保健机构院均总收入明显高于其他地区、其他级别和类型的妇幼保健机构。  结论  中国妇幼保健机构存在收入结构不合理、收入来源单一、与其他公共卫生机构相比生存压力更大等困境，急需进一步完善妇幼保健机构的投入保障机制，同时提高收入政策的灵活性。

Opportunities and challenges in cervical cancer screening program in China: SWOT analysis for implementation of program

  Objective  To examine revenue situation of maternal and child health (MCH) institutions at all administrative levels in China and to provide evidences for governmental decision-making.   Methods  The data on revenue of 3 094 MCH institutions in 31 provincial level administrative regions across the mainland of China in 2020 were collected through the national monitoring and direct reporting system for MCH institutions; other relevant information were also extracted from China Health Statistical Yearbook of 2020. The revenue and financial subsidy income of the MCH institutions in 2020 were analyzed and compared.   Results  The entire financial subsidy income of 63.09 billion yuan RMB accounted for 28.7% of the total revenue of MCH institutions in 2020 and the proportion was much lower than that for other public welfare institutions including the centers for disease control and prevention (73.6%) and health supervision institutes (91.5%). There were obvious differences in the median values (million yuan) of the revenue for the MCH institutions in various regions, at different administrative levels, and belong to different financial management categories, with significant higher medians for the MCH institutions in the eastern region (25.81), at provincial level (712.17) and under the combined financial management for public welfare of first- and second-category (70.33) compared to other MCH institutions.   Conclusion  At present, unreasonable composition, single source, and insufficient financial support are main problems for revenue of MCH institutions in China, suggesting that guarantee mechanism and policy flexibility relevant to revenue of MCH institutions need to be improved urgently.