改善孕产妇护理安全网:为非产科提供者和机构建立孕产妇死亡率监测
Joan L Combellick1,2,3, Bridget Basile Ibrahim3, Aryan Esmaeili4
1Department of Veterans Affairs, Veterans Health Administration, Office of Women's Health, 810 Vermont Ave NW, Washington, DC 20420, USA.
退伍军人健康管理局 (VA) 在2011年至2020年期间在退伍军人中确定了32起与怀孕相关的死亡. 许多死亡发生在分娩后,通常与心理健康状况和健康的社会决定因素有关.
科学领域:
- 医疗保健系统研究研究
- 孕产妇的健康结果
- 公共卫生监督是对公共卫生的监督.
背景情况:
- 孤立的孕产妇护理对孕产妇的结果产生了负面影响.
- 退伍军人健康管理局 (VA) 提供综合护理,但从外部购买产科服务.
- 在VA和社区提供者之间缺乏沟通,可能会掩盖上游的健康因素.
研究的目的:
- 描述VA的孕产妇死亡率审查过程.
- 报告使用VA产科护理的退伍军人中的孕产妇和妊娠相关死亡率.
- 确定导致退伍军人人口中怀孕相关死亡的因素.
主要方法:
- 关于怀孕和死亡的国家VA数据库的分析 (2011-2020财年).
- 个人图表审查和抽象的多专业护理.
- 专注于在怀孕前一年内获得的护理,直到死亡时刻.
主要成果:
- 在39720例怀孕中确认了32例与怀孕相关的死亡 (80.6例每10万例活产).
- 50%的死亡与不利的社会决定因素有关,81%的人患有心理健康状况.
- 50%的死亡发生在产后晚期 (43-365天),自杀,杀人或过量服用是常见的原因.
结论:
- 基于系统的方法来监测与怀孕相关的死亡,可以改善护理协调.
- 在初级,心理健康和专业服务中整合产周护理至关重要.
- 这些发现对医疗保健机构有影响,这些医疗机构需要产科和非产科提供者的协调.
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