不同性质助产机构分娩产妇围产保健获取情况比较

Comparison of the situation of obtaining perinatal care among parturient women in different kinds of midwifery institutions

目的调查不同性质助产机构产妇的围产保健获取情况,分析在孕产妇系统管理方面存在的差距,明确围产保健工作重点。方法采用分层整群随机抽样方法,抽取2014年4-6月在广州市花都区妇幼保健机构、三级综合公立医院、一级综合公立医院和民营助产机构各一间住院分娩产妇共1 406例,回顾性分析其围产保健获取情况。结果高危妊娠三级转诊得到较好落实,一级综合公立医院(27.61%)和民营医院(7.46%)高危妊娠比例明显低于妇幼保健机构(61.07%)和三级综合公立医院(53.65%)。妇幼保健机构分娩产妇围产保健获取情况整体优于其他医疗机构。民营医疗机构以流动人口为主,占72.03%,产妇围产保健获取比例较低。结论加强孕期保健宣教和流动人口管理,提高群众孕产期保健意识,针对不同性质助产机构产妇的特点,采取针对性措施,提高孕产妇的生殖保健水平。

Objective To investigate the situation of obtaining perinatal care among parturient women in different kinds of midwifery institutions, to find out the gaps in the maternal system management so as to clear up the focus on perinatal care. Methods We used stratified cluster random sampling method to select 1,406 parturient women hospitalized in a maternal and child health care agency, a third- class comprehensive public hospital, a first- class comprehensive public hospital and a private midwifery institution in Huadu District, Guangzhou City from April to June, 2014, and then the data regarding perinatal care of these women were retrospectively analyzed. Results The tertiary referral for high- risk pregnancy was implemented well. The proportions of high - risk pregnancy in the first - class comprehensive public hospital （27.61%） and the private hospital （7.46 % ） were significantly lower than those in the maternal and child health care agency （61.07 % ） and the third - class com- prehensive public hospital （53.65 % ）. The overall situation of obtaining perinatal care in the maternal and child health care agen- cy was superior to those in other medical institutions. Floating population was the major clients of the private hospital, accounting for 72.03 %, but the proportion of parturient women＇ s obtaining perinatal care was lower. Conclusions We should strength- en prenatal care propaganda and the migrant maternal management, increase the public＇s awareness of maternal health care and adopt the targeted countermeasures based on the characteristics of different kinds of midwifery institutions so as to improve the maternal health care level.