He Zhifei, Cheng Zhaohui, Wu Tailai, Zhou Yan, Chen Junguo, Fu Qian, Feng Zhanchun
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, No. 13 Hangkong Road, Wuhan, Hubei 430030, China.
School of Politics and Public Administration, Southwest University of Political Science and Law, No. 301 Baosheng Road, Chongqing 401120, China.
Biomed Res Int. 2016;2016:5685261. doi: 10.1155/2016/5685261. Epub 2016 Nov 22.
. This study aims to analyze the cesarean section (CS) rates and vaginal delivery rates in tertiary hospitals of China, explore the costs of two different deliveries, and examine the relative influencing factors of the costs in both CS and vaginal deliveries. . 30,168 anonymized obstetric medical cases were selected from three sample tertiary hospitals in Chongqing Municipality from 2011 to 2013. Chi-square test was used to compare the distributions of CS and vaginal deliveries under different indicators. Mann-Whitney test and Kruskal-Wallis test were adopted to analyze the differences under different items. Multiple linear regression was used to determine the influencing factors of the costs of different delivery modes. . (1) The rates of CS were 69%, 65.5%, and 59.2% in the three sample tertiary hospitals in Chongqing from 2011 to 2013. (2) The costs and the length of stay of CS were greater than those of vaginal delivery, which had significant differences ( < 0.005). (3) The areas, length of stay, age, medical insurance, and modes of delivery were the influencing factors of both CS and vaginal delivery costs. . The high CS rates in China must be paid significant attention. The indicators of two modes of delivery should be regulated strictly. CS rate reduction and saving medical resources will be the benefits if vaginal delivery is chosen by pregnant women.
本研究旨在分析中国三级医院的剖宫产率和阴道分娩率，探讨两种不同分娩方式的费用，并考察剖宫产和阴道分娩费用的相关影响因素。2011年至2013年，从重庆市三家抽样三级医院选取了30168例匿名产科医疗病例。采用卡方检验比较不同指标下剖宫产和阴道分娩的分布情况。采用曼-惠特尼检验和克鲁斯卡尔-沃利斯检验分析不同项目下的差异。采用多元线性回归确定不同分娩方式费用的影响因素。（1）2011年至2013年，重庆三家抽样三级医院的剖宫产率分别为69%、65.5%和59.2%。（2）剖宫产的费用和住院时间均高于阴道分娩，差异有统计学意义（<0.005）。（3）地区、住院时间、年龄、医疗保险和分娩方式是剖宫产和阴道分娩费用的影响因素。中国剖宫产率高的问题必须得到高度重视。应严格规范两种分娩方式的指标。如果孕妇选择阴道分娩，降低剖宫产率和节省医疗资源将带来益处。
