Kotelchuck M
Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill 27599-7400.
Am J Public Health. 1994 Sep;84(9):1414-20. doi: 10.2105/ajph.84.9.1414.
The assessment of the adequacy of prenatal care utilization is heavily shaped by the way in which utilization is measured. Although it is widely used, the current major index of utilization, the Kessner/Institute of Medicine Index, has not been subjected to systematic examination. This paper provides such an examination.
Data from the 1980 National Natality Survey are used to disaggregate the components of the Kessner Index for detailed analysis. An alternative two-part index, the Adequacy of Prenatal Care Utilization Index, is proposed that combines independent assessments of the timing of prenatal care initiation and the frequency of visits received after initiation.
The Kessner Index is seriously flawed. It is heavily weighted toward timing of prenatal care initiation does not distinguish timing of initiation from poor subsequent utilization, inaccurately measures utilization for full- or post-term pregnancies, and lacks sufficient documentation for consistent computer programming.
The Adequacy of Prenatal Care Utilization Index offers a more accurate and comprehensive set of measures of prenatal care utilization than the Kessner Index.
产前保健利用充分性的评估很大程度上取决于利用情况的衡量方式。尽管目前主要的利用指标——凯斯纳/医学研究所指标被广泛使用，但尚未经过系统检验。本文对此进行了检验。
利用1980年全国出生情况调查的数据对凯斯纳指标的各个组成部分进行分解，以便进行详细分析。提出了一个替代的两部分指标——产前保健利用充分性指标，该指标结合了对产前保健开始时间和开始后就诊频率的独立评估。
凯斯纳指标存在严重缺陷。它严重偏向于产前保健开始时间，没有区分开始时间和随后不佳的利用情况，对足月或过期妊娠的利用情况测量不准确，并且缺乏用于一致计算机编程的充分文档。
与凯斯纳指标相比，产前保健利用充分性指标提供了一套更准确、更全面的产前保健利用衡量标准。
