摘要
目的分析中国31省市2010—2020年儿童保健服务的基本情况和供给公平性状况。方法对国家统计局和国家卫生健康委员会公布的《中国统计年鉴》、《中国卫生健康统计年鉴》和《中国卫生和计划生育统计年鉴》中2010—2020年31省市经济水平、儿童保健情况的相关数据进行回顾性分析,采用集中指数(CI)来评价中国31省市儿童保健服务的供给公平性,并对2020年各省市的儿童保健服务情况进行聚类分析。结果2010—2020年中国31省市儿童保健服务项目中新生儿访视率、三岁以下儿童系统管理率总体呈上升趋势(χ^(2)趋势=7.602,P=0.006;χ^(2)趋势=8.233,P=0.004),围产儿死亡率逐年降低(χ^(2)趋势=9.493,P=0.002),但在2016和2020年有小幅波动;西部地区围产儿死亡率最高,中部地区儿童保健服务水平低于平均水平,但地区间差距不断减小;新生儿访视率、三岁以下儿童系统管理率的CI分别位于0.003~0.035和0.004~0.065,儿童保健服务利用集中分布于经济水平高的省市,围产儿死亡率的CI位于-0.080~-0.125,其中围产儿死亡率的不公平性最高且未有显著改善;聚类分析结果显示,除青海、新疆、安徽、海南、河南、西藏6个省(自治区)外,其他省市在儿童保健服务利用方面的相似性和差异性均可被归为相近的一类。结论过去20年间中国31省市儿童保健服务水平和服务利用公平性稳步提升,可能受到了二孩政策和新型冠状病毒肺炎等事件影响;建议继续关注围产儿死亡率,优先提高青海、新疆、安徽、海南、河南、西藏6个省(自治区)的儿童保健服务水平。
Objective To analyze the basic situation and supply equity of child health services in 31 provinces and cities in China from 2010 to 2020.Methods The relevant data of economic level and child health care of 31 provinces and cities from 2010 to 2020 in China Statistical Yearbook,China Health Statistical Yearbook,and China Health and Family Planning Statistical Yearbook published by the National Bureau of Statistics and the National Health Commission were retrospectively analyzed,and the concentration index(CI)was used to evaluate the supply equity of child health services in 31 provinces and cities in China.The cluster analysis was performed to investigate the child health care services in various provinces and cities in 2020.Results In the child health care service projects of 31 provinces and cities in China from 2010 to 2020,the neonatal visit rate and the systematic management rate of children under three years old showed an overall upward trend(χ^(2)trend=7.602,P=0.006;χ^(2)trend=8.233,P=0.004).Perinatal mortality decreased year by year(χ^(2)trend=9.493,P=0.002)but fluctuated slightly in 2016 and 2020.The perinatal mortality rate was the highest in the western region,and the level of child health care service in the central region was lower than the average,but the gap between regions was decreasing.The CIs of neonatal visit rate and systematic management rate of children under three years old were 0.003-0.035 and 0.004-0.065,respectively.The utilization of child health services was mainly distributed in provinces and cities with high economic level,and the CI of perinatal mortality ranged from-0.080 to-0.125.Among them,the unfairness of perinatal mortality was the highest and there was no significant improvement.The results of cluster analysis showed that except for Qinghai,Xinjiang,Anhui,Hainan,Henan,and Xizang,the similarities and differences in the utilization of child health services in other provinces and cities could be classified into similar categories.Conclusion The level of child health service and the fairness of service utilization in 31 provinces and cities in China have improved steadily in the past 20 years,which may be affected by the second-child policy and COVID-19.It is suggested that we continue to pay attention to perinatal mortality and give priority to improving the level of child health services in Qinghai,Xinjiang,Anhui,Hainan,Henan,and Xizang.
作者
吴际
夏瑞宏
汪晨
马德英
钱书阳
蒋春明
WU Ji;XIA Rui-hong;WANG Chen;MA De-ying;QIAN Shu-yang;JIANG Chun-ming(The Fourth Clinical Medical College of Zhejiang University of Chinese Medicine,Hangzhou,Zhejiang 310053,China;不详)
出处
《现代预防医学》
CAS
北大核心
2024年第1期99-104,共6页
Modern Preventive Medicine
关键词
儿童保健服务
集中指数
公平性
聚类分析
二孩政策
Child health service
Concentration index
Fairness
Cluster analysis
Two-child policy
COVID-19
作者简介
吴际(2000-),女,硕士在读,研究方向:儿童保健;通信作者:蒋春明,E-mail:cm_jiang@126.com。
