Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy
Abstract. Background. Regulatory policy (RP) is known as a major factor to improve health care system performance. A significant difference in maternal mortality rates (MMRs) was observed between New York city (NYC) and Shanghai (SH), both first-class international metropolises. This study aims to a...
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doaj-cce9127ff4f642ffa86d290e6782bf852020-12-02T07:57:04ZengWolters KluwerChinese Medical Journal0366-69992542-56412020-04-01133779279910.1097/CM9.0000000000000741202004050-00007Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policyLi LiCheng-Yue LiQing-Yu ZhouChuan PuLing-Zhong XuTian-Qiang XuChao HaoZhi HuMo HaoLi-Min ChenAbstract. Background. Regulatory policy (RP) is known as a major factor to improve health care system performance. A significant difference in maternal mortality rates (MMRs) was observed between New York city (NYC) and Shanghai (SH), both first-class international metropolises. This study aims to adopt a quantitative evaluation model to analyze whether RP differences contribute to the different MMRs of the two cities. Methods. Based on collection of all publicly released policy documents regarding maternal health in the two cities, we assessed and compared the status of their maternal health care RPs from 2006 to 2017 through a series of quantitative indicators as regulatory elements coverage rate (RECR), departmental responsibility clarity rate (DRCR), and accountability mechanism clarity rate (AMCR), based on two characteristics of comprehensiveness and effectiveness of RPs. Pearson correlation analysis, principal component analysis, and linear regression analysis were used to test the relationships between the indicators and MMR in SH and NYC. Results. By 2017, disparities of maternal health care RP are found between SH and NYC, from the indicators of RECR (100% vs. 77.0%), DRCR (38.9% vs. 45.1%), and AMCR (29.2% vs. 22.5%). From 2006 to 2017, RECR, DRCR, and AMCR in SH have shown a higher growth of 8.7%, 53.2%, and 45.2%, compared with growth of 25.0%, 12.5%, and 2.9% in NYC. The three indicators were found all negatively correlated with MMR in SH (Coefficients = −0.831, −0.833, and −0.909, and P < 0.01), while only RECR and DRCR had negative correlation with MMR in NYC (Coefficients = −0.736 and −0.683, and P < 0.05). Linear regression showed that the principal components of the three indicators were found with significant impact on MMRs both in SH (R = 0.914, R2 = 0.836, P < 0.001) and NYC (R = 0.854, R2 = 0.357, P = 0.04). Conclusion. Compared with NYC, the more comprehensive and effective maternal health care RPs in SH had a stronger impact on MMR control, which contributed to the differences between the two cities’ MMRs to some extent. The methods and indicators we adopted for assessment are reasonable and comparable.http://journals.lww.com/10.1097/CM9.0000000000000741 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Li Li Cheng-Yue Li Qing-Yu Zhou Chuan Pu Ling-Zhong Xu Tian-Qiang Xu Chao Hao Zhi Hu Mo Hao Li-Min Chen |
spellingShingle |
Li Li Cheng-Yue Li Qing-Yu Zhou Chuan Pu Ling-Zhong Xu Tian-Qiang Xu Chao Hao Zhi Hu Mo Hao Li-Min Chen Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy Chinese Medical Journal |
author_facet |
Li Li Cheng-Yue Li Qing-Yu Zhou Chuan Pu Ling-Zhong Xu Tian-Qiang Xu Chao Hao Zhi Hu Mo Hao Li-Min Chen |
author_sort |
Li Li |
title |
Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy |
title_short |
Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy |
title_full |
Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy |
title_fullStr |
Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy |
title_full_unstemmed |
Differences of maternal mortality rate between Shanghai and New York city from the perspective of regulatory policy |
title_sort |
differences of maternal mortality rate between shanghai and new york city from the perspective of regulatory policy |
publisher |
Wolters Kluwer |
series |
Chinese Medical Journal |
issn |
0366-6999 2542-5641 |
publishDate |
2020-04-01 |
description |
Abstract. Background. Regulatory policy (RP) is known as a major factor to improve health care system performance. A significant difference in maternal mortality rates (MMRs) was observed between New York city (NYC) and Shanghai (SH), both first-class international metropolises. This study aims to adopt a quantitative evaluation model to analyze whether RP differences contribute to the different MMRs of the two cities.
Methods. Based on collection of all publicly released policy documents regarding maternal health in the two cities, we assessed and compared the status of their maternal health care RPs from 2006 to 2017 through a series of quantitative indicators as regulatory elements coverage rate (RECR), departmental responsibility clarity rate (DRCR), and accountability mechanism clarity rate (AMCR), based on two characteristics of comprehensiveness and effectiveness of RPs. Pearson correlation analysis, principal component analysis, and linear regression analysis were used to test the relationships between the indicators and MMR in SH and NYC.
Results. By 2017, disparities of maternal health care RP are found between SH and NYC, from the indicators of RECR (100% vs. 77.0%), DRCR (38.9% vs. 45.1%), and AMCR (29.2% vs. 22.5%). From 2006 to 2017, RECR, DRCR, and AMCR in SH have shown a higher growth of 8.7%, 53.2%, and 45.2%, compared with growth of 25.0%, 12.5%, and 2.9% in NYC. The three indicators were found all negatively correlated with MMR in SH (Coefficients = −0.831, −0.833, and −0.909, and P < 0.01), while only RECR and DRCR had negative correlation with MMR in NYC (Coefficients = −0.736 and −0.683, and P < 0.05). Linear regression showed that the principal components of the three indicators were found with significant impact on MMRs both in SH (R = 0.914, R2 = 0.836, P < 0.001) and NYC (R = 0.854, R2 = 0.357, P = 0.04).
Conclusion. Compared with NYC, the more comprehensive and effective maternal health care RPs in SH had a stronger impact on MMR control, which contributed to the differences between the two cities’ MMRs to some extent. The methods and indicators we adopted for assessment are reasonable and comparable. |
url |
http://journals.lww.com/10.1097/CM9.0000000000000741 |
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