使用产妇护理沙漠来衡量获得产科护理的进展的影响:混合整数优化分析
Meghan E Meredith1, Lauren N Steimle2, Stephanie M Radke3
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Dr NW, Atlanta, GA, 30318, United States.
BMC health services research
|May 29, 2024
概括
改善孕产妇护理的机会需要的不仅仅是消除孕产妇护理沙漠. 较少设施的战略布局可以更好地服务于需要关键产科护理的妇女,特别是在农村地区.
科学领域:
- 孕产妇健康服务研究研究
- 医疗服务的可访问性
- 地理上的健康差异.
背景情况:
- 缺乏风险适当的产妇服务,特别是农村人口,有助于孕产妇的发病率和死亡率差异.
- 现有的产科护理准入措施可能无法充分为必要的设施规划提供信息.
- 本研究评估了当前访问指标如何影响新产科设施所需的数量和位置.
研究的目的:
- 评估需要的新产科护理设施的数量和位置,以改善生育年龄妇女的机会.
- 为了比较消除产妇护理沙漠与确保接近重症护理产科 (CCO) 服务的影响.
- 为扩大产科服务提供基于证据的规划提供信息.
主要方法:
- 开发了两个设施位置优化模型,以尽量减少缺乏产科护理的妇女.
- 定义的"产妇护理沙漠" (没有产科机构/提供者) 和距离CCO服务50英里以上的地区.
- 利用佐治亚州公共卫生部门的数据和美国社区调查的人口估计.
主要成果:
- 在格鲁吉亚,5.5%的生育年龄的妇女生活在产妇护理沙漠中,7.9%的妇女生活在距离CCO服务50英里之外.
- 消除产妇护理沙漠需要56个新设施 (67%的增长).
- 仅扩大8个设施,确保所有女性都能在50英里之内获得CCO服务.
结论:
- 目前的产科护理准入措施可能不足以有效规划.
- 消除格鲁吉亚所有产妇护理沙漠是资源限制.
- 需要额外的指标和工具,以根据实际需求和资源优化产科设施的安置.
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