Hemminki E, Malin M, Kojo-Austin H
Department of Public Health, University of Helsinki, Finland.
Int J Health Serv. 1990;20(2):221-32. doi: 10.2190/P7F1-PD9B-Y1XA-D9YQ.
Traditionally, the Finnish prenatal care system has been based on special maternity centers outside hospitals. In recent years, however, the use of hospital outpatient clinics has increased. The purpose of this study was to describe the use of the clinics and to see whether clinics serve as an addition or as an alternative to maternity centers. We used several different data sources (statistics, documents, interviews, questionnaires). The main source was data on visits for all women who gave birth in Helsinki in a five-week period in 1987. The content of care and means of care delivery differ between clinics and maternity centers. Clinics are technologically and provider-oriented without continuity of care. Clinics are not just referral centers for high-risk mothers; at least half of pregnant women visit them. Ultrasound screening is an important reason for use of the clinic. Background characteristics as well as the outcome of pregnancy were similar among women visiting a hospital clinic a maximum of one time (low users), two to three times, or four times or more (high users). Standardizing for the length of gestation, high users made fewer visits to maternity centers than did low users. Hospital clinic care now seems to replace care in maternity centers, and we found a weak trend toward a pluralistic prenatal care.
传统上，芬兰的产前护理系统一直基于医院外的特殊产妇保健中心。然而，近年来，医院门诊诊所的使用有所增加。本研究的目的是描述这些诊所的使用情况，并探讨诊所是作为产妇保健中心的补充还是替代。我们使用了几种不同的数据来源（统计数据、文件、访谈、问卷调查）。主要来源是1987年在赫尔辛基分娩的所有妇女在为期五周的时间段内的就诊数据。诊所和产妇保健中心在护理内容和护理提供方式上存在差异。诊所以技术和提供者为导向，缺乏连续护理。诊所不仅仅是高危母亲的转诊中心；至少一半的孕妇会去那里就诊。超声筛查是使用诊所的一个重要原因。在最多就诊一次（低就诊者）、两到三次或四次及以上（高就诊者）的医院门诊就诊的女性中，背景特征以及妊娠结局相似。在考虑妊娠期长度标准化后，高就诊者前往产妇保健中心的次数比低就诊者少。现在医院门诊护理似乎正在取代产妇保健中心的护理，并且我们发现了一种朝着多元化产前护理发展的微弱趋势。
