Longman Jo, Pilcher Jennifer M, Donoghue Deborah A, Rolfe Margaret, Kildea Sue V, Kruske Sue, Oats Jeremy J N, Morgan Geoffrey G, Barclay Lesley M
University Centre for Rural Health, University of Sydney, PO Box 3074, Lismore, NSW 2480, Australia. Email: ; ; ; ;
Women's Health and Newborn Services (Maternity) Mater Health Services, Australian Catholic University and Mater Medical Research Institute, Level 1, Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia. Email:
Aust Health Rev. 2014 Jun;38(3):337-44. doi: 10.1071/AH13188.
This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process.
Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives.
In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure.
The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.
本文阐明了准确识别产科服务的重要性。它描述了在澳大利亚为1000至25000人的社区提供服务的公立医院中,识别农村和偏远地区产科服务的数量、水平和网络的过程及挑战,并呈现了这一过程的结果。
利用卫生部门和国家政府网站以及公立医院名单,识别出澳大利亚所有在小镇提供产科服务的农村和偏远地区公立医院。查阅各州围产期报告以确定各医院的分娩数量。通过与高级辖区代表讨论,确定产科服务水平以及服务所依托的医院网络。
共识别出198家提供产科服务的农村和偏远地区公立医院。在获取产科服务信息以形成准确的全国情况方面存在挑战。各辖区集中掌握的产科服务信息性质各异,且使用不同框架来描述服务水平的最低要求。服务网络似乎基于个体联系、地理位置和交通基础设施的综合因素。
缺乏关于农村和偏远地区产科服务的现成的集中且可比的信息,对政策审查与制定、公平性、安全性和质量、网络发展与规划均有影响。服务的问责制以及识别问题的能力也受到损害。