Dobie S A, Hart L G, Fordyce M, Rosenblatt R A
Department of Family Medicine, University of Washington, Seattle.
Obstet Gynecol. 1994 Oct;84(4):557-64.
To study risk factors in a large population of women over a broad geographic area as they entered obstetric care, and to assess how they distributed themselves among the specialties.
Data from 1 year were gathered through a retrospective chart review of all women initiating care with randomly selected urban and rural obstetricians, urban and rural family physicians, and urban certified nurse midwives.
The majority of women had at least one risk factor at entry into care. When a scoring system was applied to the data, 13.5% of the women were designated "high risk," which is consistent with findings of other studies. However, women did not distribute themselves to provider types according to risk. Higher-risk women were more likely to choose family physicians, especially in rural areas. Much of this difference can be attributed to young maternal age, late entry into care, and lack of health insurance or Medicaid sponsorship.
These findings suggest that economics and geography are more likely to influence a woman's initial choice of provider than medical and obstetric risk.
研究广大地理区域内大量进入产科护理的女性的风险因素，并评估这些因素在不同专业间的分布情况。
通过对所有开始接受护理的女性的病历进行回顾性审查收集数据，这些女性由随机选择的城乡产科医生、城乡家庭医生以及城市认证护士助产士提供护理。
大多数女性在开始接受护理时至少有一个风险因素。当对数据应用评分系统时，13.5%的女性被认定为“高危”，这与其他研究结果一致。然而，女性并非根据风险选择医疗服务提供者类型。高风险女性更有可能选择家庭医生，尤其是在农村地区。这种差异很大程度上可归因于产妇年龄小、开始接受护理时间晚以及缺乏医疗保险或医疗补助。
这些发现表明，经济因素和地理位置比医疗及产科风险更有可能影响女性对医疗服务提供者的初始选择。
