Hueston W J, McClaflin R R, Mansfield C J, Rudy M
St. Claire Medical Center, Morehead, Kentucky.
Obstet Gynecol. 1994 Oct;84(4):579-82.
To evaluate the influence of socioeconomic factors and provider characteristics on the use of intrapartum epidural anesthesia.
A total of 8229 deliveries at five hospitals were reviewed retrospectively. Bivariate analysis was performed to identify potential biases in epidural use. Logistic regression was performed to control for confounding variables.
Epidural use was predominantly related to parity, with nulliparous women more likely to use an epidural during labor. In hospitals where epidurals were used in a higher percentage of women, we found an association between the woman's insurance status and the specialty of the physician managing labor. Race also appeared to be associated with epidural use in the participating hospital that had a large non-white population.
Use of intrapartum epidural analgesia varies considerably among sites and is associated with nulliparity, higher maternal age, and several nonclinical factors.
评估社会经济因素及医疗服务提供者特征对产时硬膜外麻醉使用情况的影响。
回顾性分析五家医院共8229例分娩病例。进行双变量分析以确定硬膜外麻醉使用中的潜在偏倚。采用逻辑回归分析以控制混杂变量。
硬膜外麻醉的使用主要与产次有关，初产妇在分娩期间更有可能使用硬膜外麻醉。在硬膜外麻醉使用率较高的医院，我们发现产妇的保险状况与负责分娩的医生专业之间存在关联。在非白人人口众多的参与研究医院中，种族似乎也与硬膜外麻醉的使用有关。
产时硬膜外镇痛的使用在不同地点差异很大，且与初产、产妇年龄较大以及一些非临床因素有关。
