一个地理空间分析的差异在获取胎服务的差异
Benjamin J Peipert1, Nivedita R Potapragada2, Paul M Lantos3
1Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina.
JAMA oncology
|August 10, 2023
概括
数以百万计的生育年龄妇女无法获得生育保护服务,尤其是在没有授权的州. 改善对癌症中心的地理准入对于公平的癌症护理至关重要.
科学领域:
- 在瘤学瘤学.
- 生殖医学 生殖医学
- 地理空间健康分析
背景情况:
- 对于希望在未来获得生育能力的癌症患者来说,保持生育能力 (FP) 是至关重要的.
- 公平获得FP服务,包括卵细胞和胚胎冷保存,对于全面的癌症治疗至关重要.
- 地理位置靠近生育中心显著影响患者的准入.
研究的目的:
- 绘制美国生育中心分布的地图.
- 量化缺乏地理上获得FP服务的生育年龄妇女的数量.
- 检查地理接入和国家FP授权之间的关系.
主要方法:
- 使用2小时的旅行时间同步的横截面地理空间分析.
- 根据特定的冷保存和服务标准,确定子生育中心.
- 利用美国人口普查数据来估计生育年龄的女性人口.
主要成果:
- 18.9%的生育诊所不符合生育中心的标准.
- 360万 (5.70%) 处于生育年龄的妇女在地理位置上无法进入生育中心.
- 与没有FP授权的国家相比,具有FP授权的国家具有更高的地理接入率 (98.54%) (79.57%).
- 差异在山区西部和西部北中部地区最为明显.
结论:
- 在获得生育保护服务方面存在显著的地理差异.
- 缺乏机会是对生育年龄的个体进行全面的癌症护理的主要障碍.
- 需要对生育中心的战略扩张和支持性的国家政策来改善公平的获取.
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