Paredes-Cruz Martín, Perez-Moran Diana, Doubova Svetlana V, Arsenault Catherine, Quinzaños-Fresnedo Claudio
Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
Department of Global Health. Milken Institute School of Public Health, The George Washington University, Washington District of Columbia, United States of America.
PLoS One. 2025 Aug 12;20(8):e0323039. doi: 10.1371/journal.pone.0323039. eCollection 2025.
The study aimed to evaluate healthcare use during the postnatal period for mothers and their babies, the content of care received, mothers' perceived quality of care, and the factors influencing these perceptions.
The study analyzed data from a postnatal survey conducted within the maternal eCohort at the Mexican Institute of Social Security (IMSS). The research involved 973 women aged 18-49 who were recruited following their first antenatal care visit with a family physician at 48 family medicine clinics across eight Mexican states. We described postnatal care (PNC) use, content of care and perceived quality and used Poisson multivariable regression analysis to investigate the factors influencing women's perceptions of higher quality of care during PNC.
29.4% of women and 12.0% of infants had no postnatal care visits within the six weeks following hospital discharge. Among women who received PNC, 72.3% accessed services exclusively through IMSS, 17.7% utilized a combination of IMSS and other providers, and 10% relied solely on private providers. Infants received 82.4% of recommended content of care, compared to 66.7% for mothers. The median perceived quality of care among women was 25 points on a scale of 8-40. Key areas for improvement include enhancing awareness of the importance of postnatal consultations among health personnel and women, reducing waiting times, and improving the content and length of consultations. Factors associated with better perceived quality included being over 35, receiving better content of care for infants, and being treated by private providers, while lower education levels, prior pregnancies, and poor health were associated with lower perceived quality.
Improvements are needed to ensure all women and infants receive comprehensive postnatal care and to enhance patient-perceived quality.
本研究旨在评估母亲及其婴儿产后阶段的医疗保健利用情况、所接受护理的内容、母亲对护理质量的感知以及影响这些感知的因素。
该研究分析了墨西哥社会保障局（IMSS）孕产妇电子队列中产后调查的数据。该研究涉及973名年龄在18至49岁之间的女性，她们是在墨西哥八个州的48家家庭医学诊所首次接受家庭医生产前检查后招募的。我们描述了产后护理（PNC）的使用情况、护理内容和感知质量，并使用泊松多变量回归分析来调查影响女性对PNC期间更高护理质量感知的因素。
29.4%的女性和12.0%的婴儿在出院后的六周内没有进行产后护理访视。在接受PNC的女性中，72.3%仅通过IMSS获得服务，17.7%同时利用了IMSS和其他提供者的服务，10%仅依赖私人提供者。婴儿接受了82.4%的推荐护理内容，而母亲为66.7%。女性对护理质量的感知中位数在8至40分的量表上为25分。需要改进的关键领域包括提高卫生人员和女性对产后咨询重要性的认识、减少等待时间以及改善咨询的内容和时长。与更好的感知质量相关的因素包括年龄超过35岁、婴儿获得更好的护理内容以及由私人提供者治疗，而较低的教育水平、既往怀孕史和健康状况不佳与较低的感知质量相关。
需要做出改进，以确保所有女性和婴儿都能获得全面的产后护理，并提高患者对护理质量的感知。
