School of Population Health, University of Auckland, Auckland, New Zealand.
Aust N Z J Public Health. 2011 Apr;35(2):140-5. doi: 10.1111/j.1753-6405.2010.00659.x. Epub 2011 Jan 13.
To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand.
Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%).
Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay.
Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve.
确定影响新西兰早孕流产服务及时性的因素。
2009 年 2 月至 5 月期间，从 9 家流产诊所的所有患者中收集了原始数据。测量的结果是首次就诊与流产手术日期之间的延迟。对患者记录（n=2950）进行审核，以确定从进入卫生系统的第一点到流产日期之间的时间线。还邀请妇女填写一份问卷，确定影响服务获取的个人因素（n=1086，应答率=36.8%）。
与公立医院相比，选择私立诊所的女性就诊延迟时间明显更短。在控制诊所类型的情况下，选择提供药物流产或提供一日服务的诊所的女性，其就诊延迟时间更短。此外，与仅就诊一次的女性相比，与转诊医生多次就诊的女性就诊延迟时间更长。就诊时怀孕时间越早，延迟时间越长。女性的决策对就诊延迟没有显著影响。
一些诊所层面和系统层面的因素与早孕流产服务的延迟显著相关。为了确保最佳的身体和情绪结果，必须提高服务的及时性。
