Nesbitt T S, Larson E H, Rosenblatt R A, Hart L G
Department of Family Practice, University of California-Davis, Sacramento 95817, USA.
Am J Public Health. 1997 Jan;87(1):85-90. doi: 10.2105/ajph.87.1.85.
This study sought to ascertain the effects of poor local access to obstetric care on the risks of having a neonate diagnosed as non-normal, a long hospital stay, and/or high hospital charges.
Washington State birth certificates linked with hospital discharge abstracts of mothers and neonates were used to study 29809 births to residents of rural areas. Births to women from rural areas where more than two thirds of the women left for care were compared with births to women from rural areas where fewer than one third left for care.
Poor local access to providers of obstetric care was associated with a significantly greater risk of having a non-normal neonate for both Medicaid and privately insured patients. However, poor local access to care was consistently associated with higher charges and increased hospital length of stay only if the patient was privately insured.
These results indicate that local maternity services may help prevent non-normal births to rural women and, among privately insured women, might decrease use of neonatal resources.
本研究旨在确定当地产科护理服务可及性差对新生儿被诊断为异常、住院时间长和/或住院费用高的风险的影响。
将华盛顿州出生证明与母亲和新生儿的医院出院摘要相链接，用于研究农村地区居民的29809例分娩。将三分之二以上妇女外出就医的农村地区妇女的分娩情况与三分之一以下妇女外出就医的农村地区妇女的分娩情况进行比较。
对于医疗补助计划参保患者和私人保险患者而言，当地产科护理服务可及性差与新生儿异常风险显著增加相关。然而，只有当患者为私人保险时，当地护理服务可及性差才始终与更高的费用和更长的住院时间相关。
这些结果表明，当地产科服务可能有助于预防农村妇女分娩异常，并且在私人保险妇女中，可能会减少新生儿资源的使用。
