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通过改善日本围产期护理中心的地理可达性降低新生儿死亡率。

Neonatal mortality rate reduction by improving geographic accessibility to perinatal care centers in Japan.

作者信息

Aoshima Kohei, Kawaguchi Hiroyuki, Kawahara Kazuo

机构信息

Department of Health Policy Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

J Med Dent Sci. 2011 Jul 4;58(2):29-40.

Abstract

OBJECTIVES

To assess reducing travel time to perinatal care centers, and to examine whether reducing travel time influences the neonatal mortality rate (NMR).

METHODS

The travel time from a population centroid in each municipality to the nearest perinatal care center was measured using the Geographic Information System at two time points, 2002 and 2006. Areas with and without reductions in travel time were compared for changes in the NMR. The Difference-In-Difference Estimation was used to examine whether the NMR decreased in areas with reducing travel times.

RESULTS

The median travel time was reduced from 66.99 minutes in 2002 to 39.09 minutes in 2006, and the mean NMR decreased from 1.72 (2002) to 1.33 (2006). The travel time showed great disparities. Of the areas that in 2002 had travel times longer than 60 minutes, by 2006 some areas that had improved accessibility by reducing travel time also had significant reductions in the NMR compared with regions that did not reduce travel time by 2006.

CONCLUSIONS

Reducing travel time to perinatal care centers by reconsidering the location of such centers is an effective strategy to reduce the NMR in Japan.

摘要

目的

评估缩短前往围产期护理中心的时间,并研究缩短出行时间是否会影响新生儿死亡率(NMR)。

方法

利用地理信息系统在2002年和2006年这两个时间点测量了每个市的人口中心到最近围产期护理中心的出行时间。比较了出行时间减少和未减少的地区的新生儿死亡率变化情况。采用差分估计法研究出行时间减少的地区新生儿死亡率是否下降。

结果

出行时间中位数从2002年的66.99分钟降至2006年的39.09分钟,新生儿死亡率均值从2002年的1.72降至2006年的1.33。出行时间存在很大差异。在2002年出行时间超过60分钟的地区中,到2006年,一些通过缩短出行时间改善了可达性的地区与2006年未缩短出行时间的地区相比,新生儿死亡率也有显著下降。

结论

通过重新考虑围产期护理中心的位置来缩短前往这些中心的时间,是日本降低新生儿死亡率的有效策略。

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