高风险孕妇农村居民的风险适当的分娩护理
Sara C Handley1,2,3, Brielle Formanowski1, Molly Passarella1
1Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
在高风险的农村怀孕中,经常无法获得风险适当的产科护理. 种族,保险和距离等因素造成了获得必要的专业护理的重大障碍.
科学领域:
- 产科和妇科 产科和妇科
- 农村卫生 农村卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 农村医院的产科护理正在下降,这可能会限制孕妇获得风险适当的护理.
- 高风险的怀孕需要专业或亚专业的产科护理,这在农村环境中可能很少.
研究的目的:
- 确定接受风险适当分娩护理的高风险孕妇农村居民的比例.
- 确定与农村地区不充分获得风险适当的产科护理相关的因素.
主要方法:
- 采用四个美国州 (2010-2020年) 的相关生命统计数据和医院出院数据进行的横截面研究.
- 包括近20万高风险孕妇农村居民与医院分娩.
- 分析了分娩医院的孕产妇护理水平与患者的临床状况要求.
主要成果:
- 超过一半的高风险农村怀孕没有得到风险适当的护理,其中4级护理需求的比例高达72.5%.
- 美国印第安人/阿拉斯加原住民和西班牙裔个人,那些有公共保险或没有保险的人,年龄较小,教育程度较低,与设施距离较远的人面临更高的护理不足率.
- 调整后的发病率比率显示出显著的差异,特别是那些生活在离适当护理设施最远的人群 (aIRR, 23.86).
结论:
- 在高风险的孕妇农村居民中,缺乏与风险相适应的护理普遍存在.
- 与种族,民族,保险状况,教育和地理距离相关的差异突显了关键的进入障碍.
- 调查结果强调,迫切需要改善农村人口获得专业产科护理的机会.
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