St Clair P A, Smeriglio V L, Alexander C S, Connell F A, Niebyl J R
University of Washington School of Public Health and Community Medicine, Seattle.
Public Health Rep. 1990 May-Jun;105(3):264-7.
The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more likely than primiparous women to be underutilizers were also more likely to be on medical assistance and to be unemployed. These findings suggest that situational and financial barriers are not important correlates of utilization for low-income, adult women living in urban areas where there are accessible clinic facilities and public transportation. Efforts to identify and surmount other kinds of barriers may prove to be a more effective approach to prenatal outreach for women in these circumstances.
在一组低收入市中心区女性样本中，研究了产前护理的使用情况与可能阻碍获得护理的因素之间的关系。护理的情境和经济障碍并非使用情况的重要相关因素。在未经调整的分析中，只有保险状况和就业状况与使用情况相关。在所研究的社会人口学特征中，只有产次与产前护理的使用密切相关。在控制产次的情况下分析使用情况与保险状况以及使用情况与就业之间的明显关联时，这些关系的估计强度和统计学意义大幅降低。经产妇比初产妇更有可能未充分利用产前护理，她们也更有可能获得医疗救助且失业。这些发现表明，对于居住在有便捷诊所设施和公共交通的城市地区的低收入成年女性而言，情境和经济障碍并非使用情况的重要相关因素。在这些情况下，努力识别和克服其他类型的障碍可能是对女性进行更有效产前宣传的一种方法。
