1996-2020年中国五岁以下儿童死亡率的趋势:一个Joinpoint回归和相关性分析
Jian-Min Lv1, Nan Chen1, Xi-Ning He1
1Shaanxi Provincial Rehabilitation Hospital, Xi'an, China.
BMJ open
|September 24, 2024
概括
从1996年到2020年,中国显著降低了五岁以下儿童死亡率 (U5MR),农村地区的下降速度更快. 增加政府卫生支出和改善医疗保健准入是进一步减少疾病的关键,特别是先天性心脏病和意外窒息.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生经济学 卫生经济学
背景情况:
- 五岁以下儿童死亡率 (U5MR) 仍然是一个关键的全球健康指标.
- 近几十年来,中国在儿童生存方面取得了重大进展.
- 了解U5MR的趋势和决定因素对于有针对性的干预至关重要.
研究的目的:
- 从1996年到2020年,分析中国U5MR和特定原因的U5MR的年度趋势.
- 评估医疗保健系统因素,医疗支出和中国的U5MR之间的相关性.
- 确定未来U5MR减少战略的关键领域.
主要方法:
- 使用1996年至2020年的国家数据进行的回顾性观察研究.
- 加入点回归分析以建模U5MR趋势并计算年平均百分比变化 (AAPC).
- 皮尔森相关性分析检查U5MR与医疗保健系统/支出指标之间的关系.
主要成果:
- 中国的U5MR显著下降,AAPC为-7.27% (p<0.001),农村U5MR的下降速度快于城市.
- 肺炎显示U5MR降低速度最快;先天性心脏病和意外窒息降低速度最慢.
- 医院分娩率,新生儿访问和卫生管理与U5MR有负相关性;政府卫生支出显示出负相关性,而自付支出显示出正相关性.
结论:
- 在1996年至2020年期间,中国在减少U5MR方面取得了重大进展.
- 在U5MR中,农村和城市之间的差距已经缩小,但农村地区需要继续关注.
- 未来的战略应优先考虑农村健康,解决先天性心脏病和意外窒息等特定原因,加强卫生政策,增加政府卫生支出.
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