旅行负担与产前护理利用的关联,在提供者选择后会发生什么
Songyuan Deng1, Yuche Chen2, Kevin J Bennett3
1University of South Carolina School of Medicine, Columbia, SC, USA. songyuan@email.sc.edu.
BMC health services research
|July 9, 2024
概括
交通障碍显著影响产前护理 (PNC) 的利用. 较长的旅行距离和较高的旅行不利指数 (TDI) 与较少的及时PNC启动和较少的访问有关,尽管实际影响很小.
科学领域:
- 公共卫生 公共卫生
- 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,交通是获得足够的产前护理 (PNC) 的重要障碍.
- 仅使用距离至最近的提供者距离的先前研究可能会高估获取不平等,并错过感知到的旅行负担.
- 本研究检查了与PNC利用有关的旅行距离和感知旅行负担 (TDI).
研究的目的:
- 调查到最初和主要产前护理提供者的旅行距离和感知到的旅行负担与PNC使用之间的关联.
- 区分旅行负担对提供者选择和护理利用的影响.
- 评估PNC访问上旅行负担的实际意义.
主要方法:
- 从南卡罗来纳州的医疗补助申请 (2015-2018) 中对25801名活产儿进行了回顾性队列研究.
- 通过谷歌地图计算的旅行距离;根据试点调查数据估计的旅行不利指数 (TDI).
- 通过启动和频率测量PNC利用率;使用重复测量逻辑回归和ANOVA进行分析.
主要成果:
- 平均旅行距离为24.9英里 (初始) 和24.2英里 (主要提供者),平均TDI为-11.4.
- 60%的孕妇在头三个月开始使用PNC;平均8次访问.
- 旅行距离和TDI的增加与及时启动PNC的可能性较低和访问频率减少有显著的关联.
结论:
- 旅行负担,包括距离和感知不便,在统计学上与减少产前护理使用有关.
- 尽管有统计意义,但这些发现表明,旅行负担对PNC利用的实际影响有限.
- 这凸显了了解和解决孕产妇医疗保健中运输障碍的细微方法的需要.
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