医疗保健替代子宫内器械插入的区域差异:一个回顾性队列研究
Maarten D Vink1,2, France R Portrait3, Tim van Wezep4
1Department of Health Economics, School of Business and Economics &, Talma Institute, Vrije Universiteit, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands. mdhvink@gmail.com.
BMC primary care
|August 10, 2024
概括
荷兰的初级保健机构越来越多地插入宫内器械 (IUD),一些地区的替代率更高. 这种转变与更少的随访超声波和重新安置有关,这可能会降低医疗保健成本.
科学领域:
- 医疗保健政策和经济学
- 生殖健康服务生殖健康服务
- 初级保健领域的创新.
背景情况:
- 医疗保健支出不断增加,需要像医疗保健替代等节省成本的策略.
- 从医院转移到初级保健机构的服务,如宫内器件 (IUD) 插入,是一个关键的例子.
- 对IUD插入替代品的区域差异的评估对于务实的医疗保健规划至关重要.
研究的目的:
- 评估荷兰医疗保健替代子宫内装置 (IUD) 插入的区域差异.
- 调查初级和二级保健机构之间的随访超声波和IUD再插入率的差异.
主要方法:
- 在2016-2020年期间,荷兰初级和二级保健中进行了840,766次宫内节育器插入的回顾性分析.
- 根据病例组合调整的IUD插入率,按地区和护理环境进行比较.
- 评估后续超声波和在三个月内重新安置的比例.
主要成果:
- 74%的IUD插入发生在初级保健中,从2016年到2020年间从70%增加到77%.
- 区域IUD插入替代率差异很大,从58%到82%.
- 与二级护理相比,初级护理导致的随访超声波 (3%对23%) 和重新安置 (2%对6%) 显著减少.
结论:
- 在荷兰,宫内避孕套的插入越来越多地转移到初级保健中,其替代率在区域范围内高达80%.
- 在初级保健中替代IUD插入与随访超声波和再插入率的降低有关.
- 这一趋势表明,有可能节省成本并改善获得生殖健康服务的机会.
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