贵州省惠水县新农合和降消项目实施对孕产妇妊娠结局影响

Guizhou province Huishui county new rural and reducing and eliminating the project implementation influence pregnancy outcome of pregnant women

目的探讨贵州省惠水县实施新农合和降消项目对孕产妇妊娠结局的影响。方法采用回顾性调查分析方法,基于惠水县医疗机构、户籍档案、新型农村合作医疗(新农合)工作组、降低孕产妇死亡率和消除新生儿破伤风项目(降消)工作小组工作成果报告,对数据进行统计分析。结果未开展项目(1996-1999年)、降消项目开展中(2000-2003年)、新农合联合降消项目开展中(2004-2007年),孕妇死亡率、住院分娩率、新生儿破伤风率、新法接生率、高危孕妇住院分娩率、产检覆盖率显著提高,差异具有统计学意义(P<0.05);开展降消项目后农村住院分娩率、农村低保家庭产妇产检率显著提高,差异具有统计学意义(P<0.05);开展新农合后,农村住院生产率显著提高,农村城镇产检覆盖、住院分娩率均显著提高,差异具有统计学意义(P<0.05)。结论降消项目执行后,惠水县孕产妇接受医疗保健情况显著好转,孕产妇死亡率及新生儿破伤风率显著降低,农村低保家庭产妇产检率改善效果显著;新农合开展后,农村产妇住院分娩率显著提高,但城镇低保家庭孕产妇其产检率未见显著提高;惠水县两项医疗制度成效显著,但惠及城镇低保家庭不足,应予以重视;新农合政策与降消项目存在一定重叠,新农合执行后,接受降消产妇比例显著下降,两个项目同时开展效果显著。

[ Objective ] To exPlore the implementation of new rural cooPerative medical system of Huishui county and reducing and eliminating the Project imPact on maternal, aPPlication and evaluation of the value of the Policy. [ Methods ] A retrosPective investigation and analysis taking Huishui County medical institutions, census register, ＂new rural cooPerative medical system （NCMS）working grouP＂, ＂reducing and eliminating＂ working grouP and other relevant data, the data for statistical Processing and analysis comParison. [ Results ] Not to carry out the Project from 1996 to 1999, ＂reducing and eliminating＂ Projectcarried out in 2000 to 2003, ＂new＂ and ＂reducing and eliminating＂ Project carried out in 2004 to 2007 years of maternal death cases, the rate of delivery in hosPital, the rate of neonatal tetanus, the birth rate, high-risk Pregnant womenhosPitalized delivery rate, Production insPection coverage rate significantly （P〈0.05）; carry out the ＂reducing and eliminating the Project＂ after the rural hosPital delivery rate, rural minimal assurance family labor insPection rate increased significantly （P〈0.05）; carry out the ＂new＂, the rural hosPital ProductivityimProved significantly, urban and rural antenatal examination coverage, hosPitaldelivery rate were significantly increased （P〈0.05）. [ Conclusion ] ＂Reducing and eliminating the Project after the imPlementation of＂ Huishui County maternalmedical conditions significantly imProved, the mortality rate and to decrease the rate of neonatal tetanus, rural minimal assurance family labor detection rate isimProved remarkably; ＂new＂ after the launch, rural maternity hosPital delivery rateincreased significantly, but the maternal towns minimal assurance family the birthrate did not significantly increase; Huishui County, two medical system with remarkable results, but the benefit towns minimal assurance family Problems,should be Paid more attention to; ＂new Policy＂ and the ＂reducing and eliminating＂Project has some overlaP, ＂new＂, the ＂reducing and eliminating＂ maternal ratiodecreased significantly, ＂reducing and eliminating＂ Project ＂new＂ comPared tolower utility.