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[1999年至2001年里约热内卢市公立和私立妇产中心样本中围产期发病率和死亡率的相关因素]

[Factors associated with perinatal morbidity and mortality in a sample of public and private maternity centers in the City of Rio de Janeiro, 1999-2001].

作者信息

Leal Maria do Carmo, Gama Silvana Granado Nogueira da, Campos Mônica Rodrigues, Cavalini Luciana Tricai, Garbayo Luciana Sarmento, Brasil Carla Lopes Porto, Szwarcwald Célia Landmann

机构信息

Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

出版信息

Cad Saude Publica. 2004;20 Suppl 1:S20-33. doi: 10.1590/s0102-311x2004000700003. Epub 2004 May 20.

DOI:10.1590/s0102-311x2004000700003
PMID:16636732
Abstract

This study compares socio-demographic factors, mothers' biological characteristics, and quality of care at maternity hospitals in the City of Rio de Janeiro, Brazil. A sample of 10,072 post-partum women in 47 hospitals was selected. Data were collected by interviewing mothers in the immediate post-partum and from medical records. The chi2 test was used to analyze homogeneity of ratios. Significant differences were found between patients in public and private hospitals in relation to family support, healthy habits during pregnancy, reproductive history, access to and satisfaction with prenatal care and delivery, and particularly adverse effects in the newborns. Private maternity hospitals showed better results, although they displayed excessive cesarean and neonatal inter-hospital transfer rates. The stratum consisting of public Federal and State maternity hospitals received women with greater morbidity, had lower neonatal transfer rates, and received a more positive assessment by clients of the Unified National Health System (SUS). Private maternity centers contracted out by the SUS were the ones that most refused treatment to patients, leading to delays in patient care for delivery.

摘要

本研究比较了巴西里约热内卢市妇产医院的社会人口学因素、母亲的生物学特征以及护理质量。从47家医院选取了10072名产后妇女作为样本。通过在产后立即访谈母亲并查阅医疗记录来收集数据。使用卡方检验分析比率的同质性。在公立和私立医院的患者之间,在家庭支持、孕期健康习惯、生育史、产前护理和分娩的可及性与满意度,尤其是新生儿的不良反应方面发现了显著差异。私立妇产医院的结果更好,尽管它们的剖宫产率和新生儿院际转运率过高。由联邦和州立公立妇产医院组成的阶层接收的产妇发病率更高,新生儿转运率更低,并且得到了统一国家卫生系统(SUS)客户的更积极评价。由SUS签约的私立妇产中心是最拒绝治疗患者的,导致分娩患者护理延误。

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