美国门诊产后护理使用的变化:潜伏类分析
Jamie R Daw1, Nina R Joyce2, Erika F Werner3
1Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York.
概括
产后护理模式有很大差异,近三分之一的人没有得到任何护理,近一半的人得到了面向问题的护理. 这些模式与临床风险和严重的孕产妇发病率相关,突出显示出需要量身定制的产后健康战略.
科学领域:
- 生殖健康 生殖健康
- 医疗保健服务研究 医疗服务研究
- 孕产妇健康 孕产妇健康
背景情况:
- 在美国,产后医疗保健在日常访问之外的理解有限.
- 需要描述多样化的门诊产后护理模式.
研究的目的:
- 描述门诊产后护理模式的变化.
- 确定具有类似产后护理利用率的患者子组.
主要方法:
- 使用国家商业索赔数据进行纵向队列研究.
- 隐性类分析以确定出生后60天内产后护理模式.
- 基于社会人口结构,临床因素,支出和不良事件的类别比较.
主要成果:
- 确定了六种不同的门诊产后护理模式,分为没有护理 (32.4%),仅预防性护理 (18.3%) 和问题护理 (49.3%).
- 临床风险因素在护理模式组之间逐渐增加.
- 严重的孕产妇发病率在高问题护理组 (第5和第6类) 中最高.
结论:
- 目前产后护理模式异质,与临床风险有关.
- 产后护理的重新设计和测量应该承认这种多样性.
- 需要量身定制的策略来解决不同的产后护理需求和风险.
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