本文關(guān)鍵詞： 孕產(chǎn)期保健服務(wù) 社會(huì)生態(tài)系統(tǒng)理論 影響因素 新型農(nóng)村合作醫(yī)療 計(jì)劃生育政策 流動(dòng)人口 城鄉(xiāng)比較　出處：《浙江大學(xué)》2014年博士論文　論文類(lèi)型：學(xué)位論文

【摘要】：研究背景 良好的孕產(chǎn)期保健可以改善母嬰健康狀況,顯著降低孕產(chǎn)婦死亡率和嬰兒死亡率。盡管我國(guó)孕產(chǎn)期保健服務(wù)已取得了較大發(fā)展,但還是存在各種各樣的問(wèn)題,制約著孕產(chǎn)期保健服務(wù)的利用,育齡婦女對(duì)孕產(chǎn)期保健服務(wù)的利用存在著較大的差異。 社會(huì)生態(tài)系統(tǒng)理論是用以考察人類(lèi)行為與社會(huì)環(huán)境交互關(guān)系的理論,強(qiáng)調(diào)生態(tài)環(huán)境(人的生存系統(tǒng))對(duì)于分析和理解人的行為的重要性。該理論認(rèn)為人的生存環(huán)境的微觀(guān)、中觀(guān)和宏觀(guān)系統(tǒng)總是處于相互影響和相互作用的情境中。從社會(huì)生態(tài)系統(tǒng)理論的視角,可以提出假設(shè)：孕產(chǎn)期婦女個(gè)人及其所在的家庭、社會(huì)環(huán)境構(gòu)成與其產(chǎn)生交互作用的因素,影響孕產(chǎn)期保健服務(wù)的利用。本文將從社會(huì)生態(tài)系統(tǒng)的視角,于微觀(guān)、中觀(guān)和宏觀(guān)層面對(duì)我國(guó)孕產(chǎn)期保健利用現(xiàn)狀進(jìn)行分析,探索孕產(chǎn)期保健服務(wù)利用的影響因素。 研究目的 基于社會(huì)生態(tài)系統(tǒng)理論的視角,從個(gè)人、家庭、社會(huì)三個(gè)層面探索影響孕產(chǎn)期保健服務(wù)利用的影響因素。 研究方法 研究方法包括文獻(xiàn)法和調(diào)查法,其中文獻(xiàn)法主要是通過(guò)對(duì)國(guó)家衛(wèi)生部門(mén)官方發(fā)布的社會(huì)經(jīng)濟(jì)發(fā)展和衛(wèi)生保健事業(yè)發(fā)展的相關(guān)數(shù)據(jù)進(jìn)行二次分析,對(duì)我國(guó)孕產(chǎn)期保健情況、社會(huì)因素對(duì)孕產(chǎn)期保健服務(wù)的影響等方面開(kāi)展科學(xué)評(píng)價(jià)。 調(diào)查法是通過(guò)定量調(diào)查的方式,分別采用2008年、2011年浙江省衛(wèi)生服務(wù)調(diào)查的數(shù)據(jù),以及通過(guò)自行組織的在江蘇省開(kāi)展的孕產(chǎn)期保健服務(wù)調(diào)查的數(shù)據(jù),開(kāi)展實(shí)證研究。 結(jié)果 孕產(chǎn)期保健服務(wù)利用受到來(lái)自孕產(chǎn)期女性個(gè)人、家庭、社會(huì)環(huán)境的多個(gè)層面多種社會(huì)因素的影響。值得關(guān)注的是社會(huì)環(huán)境方面的影響,通過(guò)分析發(fā)現(xiàn),流動(dòng)人口、城鄉(xiāng)差別、新型農(nóng)村合作醫(yī)療以及計(jì)劃生育政策等宏觀(guān)社會(huì)因素影響婦幼保健服務(wù)的利用。 隨著新農(nóng)合等一些衛(wèi)生籌資制度改革的實(shí)施,農(nóng)村孕產(chǎn)期保健水平得到有效提升,城鄉(xiāng)保健服務(wù)利用差距不斷縮小,但城市中流動(dòng)孕產(chǎn)婦的保健缺失,給城市孕產(chǎn)期保健工作帶來(lái)新的壓力。社會(huì)政策中,我國(guó)奉行多年的計(jì)劃生育政策在控制人口增長(zhǎng)、保障人口質(zhì)量的同時(shí),也導(dǎo)致了一部分計(jì)劃外分娩人群孕產(chǎn)期保健服務(wù)利用的缺失或不足。 結(jié)論 在繼續(xù)推進(jìn)新型農(nóng)村合作醫(yī)療的同時(shí),應(yīng)進(jìn)一步論證其補(bǔ)償方案的合理設(shè)計(jì),結(jié)合孕產(chǎn)期保健的補(bǔ)償內(nèi)容,使其能有效減輕農(nóng)村孕產(chǎn)期保健的經(jīng)濟(jì)負(fù)擔(dān)。城市孕產(chǎn)期保健工作中應(yīng)采取積極措施提高流動(dòng)人口的孕產(chǎn)期保健服務(wù)可及性。在計(jì)劃生育國(guó)策背景下,計(jì)劃外分娩的人群成為客觀(guān)上孕產(chǎn)期保健服務(wù)利用不足的特殊人群,這一現(xiàn)象成為一些經(jīng)濟(jì)發(fā)達(dá)地區(qū)提高孕產(chǎn)期保健服務(wù)利用的“瓶頸”,應(yīng)給予充分關(guān)注。
[Abstract]:Research background. Good maternal and parturient health care can improve maternal and child health and significantly reduce maternal mortality and infant mortality. Although health care services during pregnancy and childbirth in China have made great progress, there are still various problems. The utilization of health care services during pregnancy and childbirth is restricted, and there are great differences in the utilization of health care services during pregnancy and childbirth among women of childbearing age. The theory of social ecosystem is used to examine the interaction between human behavior and social environment, emphasizing the importance of ecological environment (human survival system) in analyzing and understanding human behavior. The meso and macro systems are always in the context of interaction and interaction. From the perspective of social ecosystem theory, the hypothesis can be put forward: an individual woman during pregnancy and childbirth and her family, The factors that affect the utilization of health care services during pregnancy and childbirth are affected by the interaction of social environment. This paper will analyze the present situation of health care utilization during pregnancy and childbirth in China from the perspective of social ecosystem, at the micro, meso and macro levels. To explore the factors influencing the utilization of health care services during pregnancy and childbirth. Research purpose. Based on the theory of social ecosystem, the factors influencing the utilization of health services during pregnancy and childbirth were explored from three aspects: individual, family and society. Research method. The research methods include the literature method and the investigation method, in which the literature method is mainly based on the secondary analysis of the relevant data on the social and economic development and the development of the health care enterprise, which are officially released by the state health sector, and the situation of health care during pregnancy and childbirth in China. The impact of social factors on maternal health services and other aspects of scientific evaluation. The method of investigation is to use the data of Zhejiang health service survey on 2008 and 2011, and the data of self-organized survey of pregnant and parturient health services in Jiangsu Province, respectively, to carry out empirical research through the way of quantitative investigation. Results. The utilization of health care services during pregnancy and childbirth is influenced by many social factors, including individual, family, and social environment of women during pregnancy and childbirth. What is worth paying attention to is the impact of social environment. Through analysis, it is found that floating population, urban and rural differences, New rural cooperative medical care and family planning policy and other macro social factors affect the utilization of maternal and child health services. With the implementation of some health financing system reform, such as the New Rural Cooperation (NCMS), the level of health care during pregnancy and childbirth in rural areas has been effectively improved, and the gap in the utilization of health services between urban and rural areas has been narrowing, but the health care of mobile pregnant women in cities is missing. In the social policy, our country pursues the family planning policy for many years while controlling the population growth and ensuring the quality of the population. It also leads to the lack or insufficiency of maternal health services in some unplanned delivery groups. Conclusion. While continuing to promote the new rural cooperative medical system, it is necessary to further demonstrate the reasonable design of its compensation scheme, and to combine the compensation content of the health care during pregnancy and childbirth. We should take active measures to improve the accessibility of maternal health care for the floating population. In the context of the national policy of family planning, we should take active measures to improve the accessibility of health care services in the period of pregnancy and childbirth in rural areas, and in the context of the national policy of family planning, The unplanned delivery group has become a special group with insufficient utilization of health care services during pregnancy and parturition objectively. This phenomenon has become a "bottleneck" in improving the utilization of health care services during pregnancy and childbirth in some economically developed areas, and should be given full attention.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R715.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馮星淋;楊青;徐玲;王燕;郭巖;;中國(guó)實(shí)現(xiàn)聯(lián)合國(guó)千年發(fā)展目標(biāo)5的進(jìn)程和挑戰(zhàn)(英文)[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2011年03期

2 陳健生;新型農(nóng)村合作醫(yī)療籌資制度的設(shè)計(jì)與改進(jìn)[J];財(cái)經(jīng)科學(xué);2005年01期

3 劉素蓮;賴(lài)素華;連淑珍;羅慶賢;;永安市孕產(chǎn)婦系統(tǒng)保健管理現(xiàn)狀分析與對(duì)策探討[J];當(dāng)代醫(yī)學(xué);2010年31期

4 王文利;;甘肅新型農(nóng)村合作醫(yī)療存在的問(wèn)題與對(duì)策[J];甘肅社會(huì)科學(xué);2009年02期

5 孫淑云;;新型農(nóng)村合作醫(yī)療社會(huì)關(guān)系及其利益沖突的分析——基于新型農(nóng)村合作醫(yī)療立法依據(jù)的視域[J];甘肅社會(huì)科學(xué);2009年03期

6 余澄;;我國(guó)各地區(qū)醫(yī)療衛(wèi)生服務(wù)水平評(píng)價(jià)研究——基于因子分析和聚類(lèi)分析方法[J];經(jīng)濟(jì)視角(下);2011年12期

7 徐飛亮;;社會(huì)生態(tài)系統(tǒng)理論視域下的低碳經(jīng)濟(jì)探微[J];世紀(jì)橋;2011年05期

8 付艷娥;;基層?jì)D幼保健工作的思考[J];內(nèi)蒙古中醫(yī)藥;2012年03期

9 劉英濤;陳剛;呂軍;張德英;張立;;流動(dòng)人口婦女孕產(chǎn)期保健服務(wù)利用狀況分析[J];中國(guó)全科醫(yī)學(xué);2006年07期

10 趙德學(xué),方漢琴,高永慶;略陽(yáng)縣婦幼保健工作現(xiàn)狀分析與對(duì)策[J];國(guó)外醫(yī)學(xué).婦幼保健分冊(cè);2002年Z1期

，

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