Hogg W E, Calonge N
Can Fam Physician. 1988 Sep;34:1943-6.
Primarily because of improvements in care of the low-birthweight neonate, Canada's neonatal mortality rates have declined significantly over the last 20 years. To make further improvement, research is now focused on the prevention of prematurity. However, benefits from the implementation of such research and the maintenance of the current neonatal mortality rate depend on the availability of obstetric care providers in rural areas. The recent trend among family physicians to drop the practice of obstetrics significantly jeopardizes access to obstetric care for inhabitants of rural areas, and a significant body of literature suggests that such declines in access will be accompanied by an increase in the neonatal death rate. A logical research agenda for rural family physicians would include the forecasting of the effect of the decrease in obstetric care manpower, follwed by the study of factors behind this trend, and the evaluation programs designed to prevent family physicians abandoning obstetric practice.
主要由于低体重新生儿护理水平的提高,加拿大的新生儿死亡率在过去20年中显著下降。为了进一步改善,目前的研究重点是预防早产。然而,此类研究的实施以及维持当前新生儿死亡率所带来的益处,取决于农村地区产科护理人员的可获得性。家庭医生近期放弃产科业务的趋势,严重危及农村地区居民获得产科护理的机会,并且大量文献表明,这种获得护理机会的减少将伴随着新生儿死亡率的上升。农村家庭医生合理的研究议程应包括预测产科护理人力减少的影响,接着研究这一趋势背后的因素,以及评估旨在防止家庭医生放弃产科业务的项目。