Impact of new health care reform on enabling environment for children's health in China: An interrupted time-series study

作者全名："Huangfu, Huihui; Zhang, Zhifan; Yu, Qinwen; Zhou, Qingyu; Shi, Peiwu; Shen, Qunhong; Zhang, Zhaoyang; Chen, Zheng; Pu, Chuan; Xu, Lingzhong; Hu, Zhi; Ma, Anning; Gong, Zhaohui; Xu, Tianqiang; Wang, Panshi; Wang, Hua; Hao, Chao; Li, Chengyue; Hao, Mo"

作者地址："[Huangfu, Huihui; Zhang, Zhifan; Yu, Qinwen; Zhou, Qingyu; Li, Chengyue; Hao, Mo] Fudan Univ, Res Inst Hlth Dev Strategies, 2 Yitaili Bldg,Room 606,446 Zhaojiabang Rd, Shanghai 200032, Peoples R China; [Huangfu, Huihui; Zhang, Zhifan; Yu, Qinwen; Zhou, Qingyu; Shi, Peiwu; Shen, Qunhong; Zhang, Zhaoyang; Chen, Zheng; Pu, Chuan; Xu, Lingzhong; Hu, Zhi; Ma, Anning; Gong, Zhaohui; Xu, Tianqiang; Wang, Panshi; Wang, Hua; Hao, Chao; Li, Chengyue; Hao, Mo] Fudan Univ, Collaborat Innovat Ctr Social Risks Governance Hl, Shanghai, Peoples R China; [Shi, Peiwu] Zhejiang Acad Med Sci, Hangzhou, Zhejiang, Peoples R China; [Shen, Qunhong] Tsinghua Univ, Sch Publ Policy & Management, Beijing, Peoples R China; [Zhang, Zhaoyang] Natl Hlth Commiss Peoples Republ China, Project Supervis Ctr, Beijing, Peoples R China; [Chen, Zheng] Chinese Prevent Med Assoc, Dept Grassroots, Publ Hlth Management Grp, Publ Hlth Management Branch, Shanghai, Peoples R China; [Pu, Chuan] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China; [Xu, Lingzhong] Shandong Univ, Sch Publ Hlth, Jinan, Shandong, Peoples R China; [Hu, Zhi] Anhui Med Univ, Sch Hlth Serv Management, Hefei, Anhui, Peoples R China; [Ma, Anning] Weifang Med Univ, Sch Management, Weifang, Shandong, Peoples R China; [Gong, Zhaohui] Cent Comm China ZHI GONG PARTY, Comm Med & Hlth, Beijing, Peoples R China; [Xu, Tianqiang] Shanghai Municipal Hlth Commiss, Inst Inspect & Supervis, Shanghai, Peoples R China; [Wang, Panshi] Shanghai Municipal Hlth Commiss, Shanghai, Peoples R China; [Wang, Hua] Jiangsu Prevent Med Assoc, Nanjing, Jiangsu, Peoples R China; [Hao, Chao] Changzhou Ctr Dis Control & Prevent, Changzhou, Jiangsu, Peoples R China"

通信作者："Li, CY; Hao, M (通讯作者)，Fudan Univ, Res Inst Hlth Dev Strategies, 2 Yitaili Bldg,Room 606,446 Zhaojiabang Rd, Shanghai 200032, Peoples R China."

来源：JOURNAL OF GLOBAL HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:000773720100001

JCR分区：Q1

影响因子：7.2

年份：2022

卷号：12

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："Background Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children's health. Methods An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children's needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook. Results The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10000 population showed the fastest increase (beta(1) =0.03, P< 0.01; beta(3) =0.10, P<0.01), followed by SMCNR (beta(1) =0.94, P<0.01; beta(3) =1.83, P<0.01), AMCR (beta(1) =0.13, P<0.01; beta(3) =0.24, P=0.14), MPR (beta(1) =1.35, P<0.01; beta(3) =2.47, P<0.01) and PECR (beta(1) =1.43, P<0.01; beta(3) =1.47, P<0.01). Conclusions The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors."

基金机构："Tsien Hsue-shen Urbanology Award of Hangzhou International Urbanology Research Center & Zhejiang Urban Governance Studies Center [21QXS004]; Three-Year Action Plan of Shanghai Municipality Strengthens Public Health System Construction [GWIV-32, GWV-12]; National Natural Science Foundation of China [72074048, 71774031]; Shanghai Foundation for Talents Development [2020128]"

基金资助正文："This study was supported by Tsien Hsue-shen Urbanology Award of Hangzhou International Urbanology Research Center & Zhejiang Urban Governance Studies Center (No. 21QXS004), Three-Year Action Plan of Shanghai Municipality Strengthens Public Health System Construction (No. GWIV-32 and No. GWV-12), National Natural Science Foundation of China (No. 72074048 and No. 71774031), and the Shanghai Foundation for Talents Development (No. 2020128). The funding bodies played no role in study design, the collection, analysis, and interpretation of data, or in writing the manuscript for publication."