Giles W, Collins J, Ong F, MacDonald R
Department of Obstetrics and Gynaecology, Westmead Hospital, NSW.
Med J Aust. 1992 Aug 3;157(3):158-61.
To assess the practicality, acceptability to patients and salary costs of the antenatal care of low risk obstetric patients by midwives.
A randomised controlled trial.
The antenatal clinic at Westmead Hospital, a teaching hospital of the University of Sydney in western Sydney.
From January 1989 until November 1990, 89 women booking for full antenatal care at Westmead Hospital and classified as low risk were randomly allocated to one of two groups. Group 1 (43 patients) had their antenatal care provided by registered midwives. Group 2 (46 patients) had their antenatal care provided by an obstetrician (either Visiting Medical Officer or Staff Specialist) in a routine hospital antenatal clinic.
Patients in the midwives' clinic were seen by an obstetrician at their first visit to the antenatal clinic and again at 30 weeks and at 40 weeks.
These were the salary costs of each clinic and the patients' levels of satisfaction. Maternal and neonatal indicators, delivery details and analgesic requirements were also considered. These indicators were planned before data collection commenced.
The major differences found were a 28% to 68% salary cost saving and that patients cared for by midwives showed appreciation of the continuity of care and information given at the midwives' clinic.
The care of low risk obstetric patients by midwives in a midwives' clinic showed salary cost savings and high patient acceptance.
评估由助产士为低风险产科患者提供产前护理的实用性、患者接受度及薪资成本。
一项随机对照试验。
位于悉尼西部的悉尼大学教学医院韦斯特米德医院的产前诊所。
从1989年1月至1990年11月，89名在韦斯特米德医院预约接受全程产前护理且被归类为低风险的女性被随机分配到两组中的一组。第1组（43名患者）由注册助产士提供产前护理。第2组（46名患者）在医院常规产前诊所由产科医生（客座医务人员或专科医生）提供产前护理。
助产士诊所的患者在首次产前就诊时、孕30周及孕40周时由产科医生诊治。
这些指标为每个诊所的薪资成本以及患者的满意度水平。还考虑了孕产妇和新生儿指标、分娩细节及镇痛需求。这些指标在数据收集开始前就已确定。
发现的主要差异是薪资成本节省了28%至68%，且由助产士护理的患者对助产士诊所提供的连续护理和信息表示满意。
在助产士诊所由助产士护理低风险产科患者可节省薪资成本且患者接受度高。
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