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家庭医学在解决美国母婴健康危机中的作用。

The Role of Family Medicine in Addressing the Maternal Health Crisis in the United States.

机构信息

University of Utah, Salt Lake City, UT, USA.

University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

出版信息

J Prim Care Community Health. 2024 Jan-Dec;15:21501319241274308. doi: 10.1177/21501319241274308.

Abstract

The United States (US) is experiencing a maternal health crisis, with high rates of maternal morbidity and mortality. The US has the highest rates of pregnancy-related mortality among industrialized nations. Maternal mortality has more than quadrupled over the last decades. Rural areas and minoritized populations are disproportionately affected. Increased pregnancy-care workforce with greater participation from family medicine, greater collaborative care, and adequate postpartum care could prevent many maternal deaths. However, more than 40% of birthing people in the US receive no postpartum care. No singular solutions can address the complex contributors to the current situation, and efforts to address the crisis must address workforce shortages and improve care during and after pregnancy. This essay explores the role family medicine (FM) can play in addressing the crisis. We discuss pregnancy care training in FM residencies as well as the threats posed by financial and medico-legal climates to the maternal health workforce. We explore how collaborative care models and comprehensive postpartum care may impact the maternal health workforce. Efforts and resources devoted to high impact solutions for which FM has considerable autonomy, including collaborative and postpartum care, are likely to have greatest impact.

摘要

美国(US)正面临着一场严重的母婴健康危机,母婴发病率和死亡率居高不下。美国是工业化国家中孕产妇死亡率最高的国家。在过去几十年中,孕产妇死亡率增加了四倍多。农村地区和少数族裔人口受到的影响不成比例。增加妊娠保健劳动力,增加家庭医学的参与、更多的协作护理以及充足的产后护理,可以预防许多孕产妇死亡。然而,美国超过 40%的产妇在分娩后没有得到产后护理。没有单一的解决方案可以解决当前复杂情况的原因,解决危机的努力必须解决劳动力短缺问题,并改善妊娠期间和之后的护理。本文探讨了家庭医学(FM)在应对这一危机中可以发挥的作用。我们讨论了 FM 住院医师的妊娠护理培训,以及财务和医疗法律环境对母婴保健劳动力的威胁。我们探讨了协作护理模式和全面的产后护理如何影响母婴保健劳动力。致力于具有相当自主权的高影响力解决方案的努力和资源,包括协作和产后护理,可能会产生最大的影响。

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