社会经济因素和医疗保健覆盖情况是否会影响城市三级医院的产后绝育率？

Does socioeconomic factors and healthcare coverage affect postpartum sterilization uptake in an urban, tertiary hospital?

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama IV Road, Patum Wan, Bangkok, 10330, Thailand.

Chula Data Management Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Reprod Health. 2023 Jan 27;20(1):23. doi: 10.1186/s12978-023-01572-5.

DOI:10.1186/s12978-023-01572-5

PMID:36707807

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9881507/

Abstract

BACKGROUND

Postpartum sterilization in Thailand has relatively few barriers compared to other countries. The procedure is covered by some healthcare plans, and paid out-of-pocket for others. We aim to determine if healthcare coverage and other socioeconomic factors affect the rate of postpartum sterilization in an urban, tertiary hospital.

METHODS

We conducted a secondary analysis of data from a retrospective cohort of 4482 postpartum women who delivered at our hospital. Multivariable logistic regression was conducted to determine if sterilization reimbursement affects immediate postpartum sterilization rate.

RESULTS

Overall immediate postpartum sterilization rate was 17.8%. Route of delivery and parity were similar in those who were reimbursed and those who were not. Women aged over 25 were more likely to have a healthcare plan that does not cover postpartum sterilization. Women whose healthcare plan reimbursed the procedure trended towards postpartum sterilization when compared to women who were not (aOR 1.05, 95% CI 0.86-1.28, p-value = 0.632). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.87; 95% CI 4.77-7.24, p-value = < 0.001). Women aged 40-44 years were 2.70 times as likely to choose sterilization than those aged 20-24 years (aOR = 2.70; 95% CI 1.61-4.53, p-value < 0.001).

CONCLUSIONS

Healthcare coverage of the procedure was not associated with increased postpartum sterilization in our setting.

摘要

背景

与其他国家相比，泰国的产后绝育手术障碍相对较少。该手术被一些医疗保健计划涵盖，而另一些则需要自费。我们旨在确定医疗保健覆盖范围和其他社会经济因素是否会影响一家市级三级医院产后绝育的比率。

方法

我们对在我院分娩的 4482 名产后妇女的回顾性队列数据进行了二次分析。采用多变量逻辑回归来确定绝育报销是否会影响产后立即绝育的比率。

结果

总体而言，产后立即绝育率为 17.8%。在获得报销和未获得报销的女性中，分娩方式和产次相似。年龄在 25 岁以上的女性更有可能拥有不涵盖产后绝育的医疗保险计划。与未获得报销的女性相比，医疗保险计划报销该手术的女性更倾向于进行产后绝育（优势比 1.05，95%置信区间 0.86-1.28，p 值=0.632）。经剖宫产分娩的女性更有可能在分娩时进行绝育（优势比=5.87；95%置信区间 4.77-7.24，p 值<0.001）。40-44 岁的女性选择绝育的可能性是 20-24 岁女性的 2.70 倍（优势比=2.70；95%置信区间 1.61-4.53，p 值<0.001）。