Analysis Of Regional Balance In Maternal And Children Health Services Utilization And Its Change In China

Objectives Deeply used and excavated the information resources in data of National Health Services Survey ,to analyze the differences of maternal and child health services utilization in different regions,and to break through the space limitations of the regional differences in previous studies. The author found out the status of regional balance in maternal and child health services utilization from the overall national level,to try to Seek and find the potential gaps in region's equilibrium. And to provide policy ideas to solve that regional differences in maternal and child health services utilization in different regions for decision-making departments, to provide a scientific basis for rational allocation of resources for maternal and child health and improving the health of women and children in different areas.Methods The material this study used comes from the four NationaI Health Services Survey, the author abstracted the key indicators including medical and health services utilization indicators and indicators of maternal health care services utilization. Chi-square test, Index of Dissimilarity (ID) and geographical mapping were used to analyze respectively the level of relevant indicators in the maternal and child health services utilization of each survey, the equilibrium of relevant indicators in urban and rural areas and different regions, and the trends of level of relevant indicators and their balance in each survey.Results①Both statistical data and geographical distribution showed that the level of health services utilization of the female population aged 15 and children distributed approximately the same in urban and rural areas and different regions.②In 2008 survey, the level of rural health services utilization of two groups were higher than urban. The prevalence of past-two-week outpatient care using (POCU) was higher in east, north, South and Southwest;proportion of non-service using patients (PNUP) was higher in Northeast and Northwest regions; rate of annual hospital admission (RAHA) in most regions were similar.③Differences of POCU of two groups and children RAHA showed an upward tendency in entire country,inner city and countryside. Regional differences of children POCU were obviously increasing trend apart from outside North. Both female POCU and PNUP of two groups haven't clear trend. Only Individual areas such as North, Southwest, Northeast,and South showed fluctuations in the trend.④In 2008 survey, the level of the four indicators of maternal health care in urban areas was higher than that in rural areas.Early examinations rate (EER) and prenatal examination rate(PER) were lower in both urban areas and rural areas. Studies have shown that the four indicators of Southwest exist respectively the larger gap than other regional index value. Compared the level of the regions, postnatal visit rate (PVR) was the lowest in North China, while the other three indicators were higher. The four indicators were higher in the eastern coastal regions, Northeast, Central South.⑤Since 1993 ,the level of the four indicators of maternal health care had a different degree in urban and rural.and different regions. the level of EER , PER and hospital delivery rate(HDR) in rural areas increased greater than the city, especially the level of HDR. PVR increased was not large in urban and rural areas, but the city was larger than rural areas. Four indicators of regional differences for the entire country gradually reduced since 1993, the internal differences between urban and rural and regional differences are also present within the shrinking trend. Conclusions There was a clear urban-rural gap ,regional disparities and urban and rural areas within the gap in the level of maternal and child health service. The decrease in the level of imbalance there are also differences in different regions, urban and rural areas. to improve the level of maternal and child health services and increase the level of equity in health service use, need the government and the relevant functional departments in the development of the socio-economic environment ,at the same time through increased investment in health; the implementation of regional health planning, rational distribution of health resources; Improve the social medical insurance system; the development of social assistance; carry out health education ,and so on.