巴西在地理上获得配送服务的不平等
Valdemar Pinho Neto1,2, Cecilia Machado3,4, Felipe Lima3
1Center for Empirical Studies in Economics, Fundação Getúlio Vargas, Rio de Janeiro, Brazil. valdemar.pinho@fgv.br.
BMC health services research
|December 19, 2024
概括
巴西的孕妇为了分娩而旅行更远的距离,超过30%的孕妇穿越市政界限. 这种地理障碍不成比例地影响弱势群体,突出了医疗保健获取方面的差异.
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
- 空间流行病学 空间流行病学
背景情况:
- 尽管社会进步,但巴西的医疗保健机会仍然不平等.
- 交付服务的市区间旅行距离构成了重大障碍.
- 了解旅行模式对于公平的孕产妇医疗保健至关重要.
研究的目的:
- 分析2007年至2017年巴西分娩服务的市际距离的规模和趋势.
- 调查旅行距离与社会经济/风险因素之间的关系.
- 在孕产妇医疗保健中提供地理可访问性政策的信息.
主要方法:
- 利用了巴西活产信息系统 (SINASC) 的数据 (2007-2017).
- 使用市际距离矩阵来计算行程长度.
- 进行回归分析,将行程距离与风险因素和市政社会经济决定因素联系起来.
主要成果:
- 到2017年,出差分娩的妇女比例增加到31%,平均距离接近60公里.
- 旅行距离的增加主要是由于越过市政边界的女性比例更高.
- 区域差异仍然存在;高风险怀孕和低出生体重新生儿与更长的旅行有关,而较高的市政发展与较短的距离相关.
结论:
- 到达分娩设施的长途旅行仍然是一个重大障碍,不成比例地影响脆弱的母亲.
- 决策者在规划和扩大产妇健康服务时必须优先考虑地理可访问性.
- 需要进一步的研究来探索旅行决策的细微差别和距离作为可访问性的方面.
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