我国儿童保健质量及地区差异分析

目的 评价我国儿童保健质量现状并探讨地区间差异, 为儿童保健工作规划和决策提供参考依据。方法 以2011年中国六项儿童保健指标(出生体重＜2 500 g婴儿比重、围产儿死亡率、5岁以下儿童中重度营养不良比重、新生儿访视率、3岁以下儿童系统管理率、7岁以下儿童保健管理率)为基础, 使用TOPSIS法综合评价全国31省市儿童保健质量, 并采用差异指数探讨各指标在不同地区间的差异。结果 TOPSIS法综合评价各省市儿童保健质量, 排名前三位的分别为上海(C=0.783 5)、广东(C=0.490 3)和北京(C=0.435 0), 末三位分别为湖南(C=0.063 1)、陕西(C=0.051 8)和福建(C=0.029 2);从全国范围来看, TOPSIS法儿童保健综合质量差异指数(index of dissimilarity, ID)较大(ID=0.35)。六项儿童保健质量指标中, <5岁儿童中重度营养不良比重差异指数最高(ID=0.59), 出生体重＜2 500 g婴儿比重、<3岁儿童系统管理率和7岁以下儿童保健管理率三项指标的差异指数均为0.30, 差异指数最小的为围产儿死亡率(ID=0.25)。结论 我国儿童保健质量在全国范围内分布不均衡, 需针对各指标具体情况制定相应对策, 缩小地区间差异。

Analysis of the quality of child health care and regional dissimilarity in China.

Objective To evaluate the quality of Chinese child health care status and the dissimilarity among different regions, and provide reference for child health care planning and policy-making. Methods Based on six basic child health indicators (the rate of birth weight <2 500 g, perinatal mortality, the proportion of severe malnutrition in children under 5, neonatal visit rate, system management rate of children under 3, system management rate of children under 7), TOPSIS method was used to evaluate the integrated child health care quality, the regional dissimilarity was explored by using index of dissimilarity. Results According to the Results of TOPSIS, the top three were Shanghai (C=0.783 5), Guangdong (C=0.490 3) and Beijing (0.435 0), the last three were Hunan (C=0.063 1), Shaanxi (C=0.051 8) and Fujian (C=0.029 2);Nationwide, index of dissimilarity (ID) of TOPSIS method was large(0.35).ID of the proportion of severe malnutrition in children under 5 was the largest (0.59);IDs of the rate of birth weight <2 500 g, system management rate of children under 3 and system management rate of children under 7 were equal (0.30);The smallest ID was perinatal mortality (0.25). Conclusion The child health care quality unevenly distributes across the country, and the policy maker should develop appropriate solutions to different indicators.