Objective:To describe the characteristics and medical seeking behaviors of female infertility patients in assisted reproductive institutions in China overall and geographical regions, and compare the differences among the eastern, the middle and the western regions.Methods:This study used the data from Unit 6-Analysis on the matching status of reproductive health and health care services among reproductive age population and demonstration and promotion study of diagnosis and treatment in National Key R&D Program "Reproductive Health and Major Birth Defects Prevention and Control Study" participated by the Assisted Reproductive Technology Management Department of Maternal and Child Health Care Center, Chinese Center for Disease Control and Prevention. One assisted reproductive institution with more than 1 000 and less than 1 000 oocyte retrieval cycles by in vitro fertilization techniques in 2018 was selected from 8 provincial capital cities in different regions of eastern and western China, and the questionnaire data of infertile female patients aged 20-49 years who first visited the outpatient clinics of 16 institutions were analyzed. The patient's age, degree of culture, annual personal income, try-to-conceived time, and one-way transportation time were analyzed using the frequency description, χ 2 test, Kruskal-Wallis H test and other methods. Results:A total of 3 673 female patients were finally included as study subjects. The patient's age was (31.0±4.6) years old, and 59.0% (2 156/3 660) was an undergraduate/college degree or above, with a median pregnancy test duration of 2.0 (1.3, 3.5) years. In terms of demographic characteristics, the proportion of patients over 35 years old in the eastern and western regions was greater in small institutions, 22.8% (216/948) and 26.4% (148/561), respectively. The proportion of patients with academic degrees in high school and below in the central region was higher, 49.1% (216/440) in large institutions and 47.0% (275/585) in small institutions. In terms of economics, 30.5% (521/1 708) of eastern patients reached an annual income of more than RMB 100 000, while only 2.8% (26/939) were willing to accept more than RMB 100 000 in treatment costs, and patients in the central and western regions were lower than those in the eastern region in terms of their annual income and acceptable treatment costs ( P<0.001). In terms of transportation, patients in the western region spent the longest amount of one-way transportation time, with large institutions of 30.9% (117/379) and small institutions of 29.8% (167/561) needing to spend more than 3 h; the proportion of patients in the eastern region who seek medical treatment from overseas was the highest, with 21.6% (164/758). Conclusion:The age of infertility patients in assisted reproductive institutions in China generally exceeds the optimal reproductive age of women and has a higher degree of education. Therefore, in young and people with a lower degree of education, the publicity of reproductive knowledge should be strengthened to encourage couples with fertility willingness to start preparation as early as possible. ln addition, there are more older patients in the western region, as well as the economic and transportation conditions are more unfavorable, and more attention needs to be paid at the policy level.

目的 了解京津冀地区人类辅助生殖技术服务机构(以下简称"辅助生殖机构")配置现状和地理可及性,为国家下一轮配置规划提供参考依据.方法 首先运用地图慧软件了解京津冀地区的60家辅助生殖机构的地理位置,其次对辅助生殖机构分省、分技术类别进行描述性分析,最后利用百度地图计算采用驾驶机动车方式各县(县级市、区)到京津冀地区辅助生殖机构的最短距离和最短时间并用最小值、最大值、均数±标准差等进行描述性分析.结果 京津冀地区共有辅助生殖机构60家,其中北京共18家、天津共11家、河北共31家.京津冀地区各县到人类辅助生殖技术(assisted reproductive technology,ART)/夫精人工授精(artificial insemination-husband semen,AIH)、供精人工授精(artificial insemination-donor semen,AID)、体外受精(in vitro fertilization,IVF)/卵质内单精子注射(intracytoplasmic sperm injection,ICSI)、植入前胚胎遗传学诊断(preimplantation genetic diagnosis,PGD)机构最短距离的均数分别为44.6?km、151.2?km、75.5?km、210.9?km,其中最短距离小于90.0?km的县的比例分别为92.4％、24.2％、76.7％、19.7％;京津冀地区各县到ART/AIH、AID、IVF-ET/ICSI、PGD机构最短时间的均数分别为50.9 min、136.0 min、75.4 min、185.8 min,其中最短时间小于90.0?min的县的比例分别为91.9％、23.3％、76.2％、17.5％.结论 京津冀地区辅助生殖机构配置的总体地理可及性较好,但也应采取有效措施弥补河北少部分县地理可及性的不足,并结合患者需求逐步改善AID、PGD机构的地理可及性.

进入21世纪,中国人口总量增长势头明显减弱.为解决家庭育儿负担,改善人口结构,2019年国务院颁发了《关于促进3岁以下婴幼儿照护服务发展的指导意见》,规划了婴幼儿照护服务未来五年的发展蓝图.本研究通过文献研究方法,对3岁以下婴幼儿照护服务相关政策进行梳理,并对婴幼儿照护服务模式、现状和需求、及国际经验等方面进行归纳总结,以期为落实中国3岁以下婴幼儿照护服务体系的具体构建提供政策建议和参考意见.

目的 描述西藏自治区2018年医疗卫生资源配置现状及公平性,为相关部门下一步的配置规划提供参考依据.方法 对西藏自治区医疗卫生资源配置现状进行描述性分析并通过洛伦兹曲线、基尼系数和卫生密度指数分析其配置的公平性.结果 截止2018年底,西藏自治区医疗卫生机构数、实有床位数、卫生技术人员、执业(助理)医师、注册护士分别为6845家、16787张、19085人、8322人、5573人.各类医疗卫生资源按人口配置相对公平,而按面积配置则较为不公平.林芝市和山南市的卫生密度指数高于全区水平,阿里地区和那曲市则低于全区水平.结论 2018年西藏自治区各类医疗卫生资源按人口配置较为公平,而按面积配置则较为不公平.林芝市和山南市的卫生密度指数高于西藏其他地市.

目的 分析总结国家重点研发计划专项资金经费管理的经验和做法,并提出针对性的方法和建议.方法 梳理中国疾病预防控制中心妇幼保健中心,近5年来已经完成和正在承担的国家重点研发计划专项资金经费执行过程中所涉及的预算编制、预算执行、经费调剂等一系列问题,提出具体的方法和建议.结果 国家重点研发计划在经费管理过程中需要课题组和财务人员共同参与,细化预算编制,严格执行预算,透明过程管理.单位内部科研经费管理政策和部门间建立有效的沟通机制也至关重要.结论 国家重点研发计划经费额度大,经费管理要求高,需要多方人员参与,严格管理和执行预算,这样才可以提高国家重点研发计划专项资金的使用效益,从而保证项目总体目标的实现.

目的:描述我国2018年专业公共卫生机构及其人力资源配置现状和公平性,为国家合理规划公共卫生服务资源提供数据支撑.方法:对我国各省份的专业公共卫生机构及其人力资源配置现状进行描述性分析;通过基尼系数和洛伦兹曲线分别按人口和面积分析其配置的公平性.结果:2018年我国专业公共卫生机构总数已达18 033家,专业公共卫生机构人员总数已达872 671人,但各省之间差异较大.基尼系数和洛伦兹曲线分析显示:我国疾病预防控制中心等四类机构按人口配置相对公平,而健康教育所等四类机构按人口配置较为不公平;各类专业公共卫生机构按人口配置公平性都好于按面积配置.我国专业公共卫生机构各类人力资源按人口配置相对公平,而按面积配置则较为不公平.结论:2018年我国多数专业公共卫生机构及其人力资源按人口配置较为公平且按人口配置公平性好于按面积配置,但仍存在部分地区的机构和人员配置不公平的现象.

目的:描述我国2018年人类辅助生殖技术服务机构(以下简称辅助生殖机构)配置现状及公平性,为卫生行政部门优化资源配置提供决策依据.方法:通过基尼系数和洛伦兹曲线分别按人口公平性与地理公平性分析全国及东中西部地区辅助生殖机构配置的公平性,并结合泰尔指数对区域间差异与区域内差异进行分析.结果:截止2018年底,我国共有辅助生殖机构498家,其中东、中、西部地区的辅助生殖机构数分别为264家、139家、95家.基尼系数和洛伦兹曲线分析显示:2018年全国及东中西部地区辅助生殖机构数按人口配置较为公平;东、中部地区辅助生殖机构数按面积配置相对合理,而全国及西部地区按面积配置则处于高度不公平状态.泰尔指数分析显示,东中西部地区内部和东中西部地区之间的差异对总泰尔指数的贡献率分别为63.9％和36.1％.结论:2018年全国及东中西部地区辅助生殖机构数按人口配置较为公平,按面积配置的公平性则有待提高.配置的不公平性受地区间和地区内的双重影响.今后在制定辅助生殖技术资源相关管理政策时应该改善地理公平性,加强对西部地区的医疗援助以尽可能缩小区域间和区域内差异.