低风险女性产科护理中的跨专业差异。
Interspecialty differences in the obstetric care of low-risk women.
作者信息
Rosenblatt R A, Dobie S A, Hart L G, Schneeweiss R, Gould D, Raine T R, Benedetti T J, Pirani M J, Perrin E B
机构信息
Department of Family Medicine, University of Washington School of Medicine, Seattle 98195-4795, USA.
出版信息
Am J Public Health. 1997 Mar;87(3):344-51. doi: 10.2105/ajph.87.3.344.
OBJECTIVES
This study examined differences among obstetricians, family physicians, and certified nurse-midwives in the patterns of obstetric care provided to low-risk patients.
METHODS
For a random sample of Washington State obstetrician-gynecologists, family physicians, and certified nurse-midwives, records of a random sample of their low-risk patients beginning care between September 1, 1988, and August 31, 1989, were abstracted.
RESULTS
Certified nurse-midwives were less likely to use continuous electronic fetal monitoring and had lower rates of labor induction or augmentation than physicians. Certified nurse-midwives also were less likely than physicians to use epidural anesthesia. The cesarean section rate for patients of certified nurse-midwives was 8.8% vs 13.6% for obstetricians and 15.1% for family physicians. Certified nurse-midwives used 12.2% fewer resources. There was little difference between the practice patterns of obstetricians and family physicians.
CONCLUSIONS
The low-risk patients of certified nurse-midwives in Washington State received fewer obstetrical interventions than similar patients cared for by obstetrician-gynecologists or family physicians. These differences are associated with lower cesarean section rates and less resource use.
目的
本研究调查了产科医生、家庭医生和认证助产士在为低风险患者提供产科护理模式上的差异。
方法
从华盛顿州的产科医生、妇科医生、家庭医生和认证助产士中随机抽取样本，提取他们在1988年9月1日至1989年8月31日期间开始护理的低风险患者的随机样本记录。
结果
认证助产士使用连续电子胎儿监护的可能性较小，引产或加强宫缩的发生率低于医生。认证助产士使用硬膜外麻醉的可能性也低于医生。认证助产士护理的患者剖宫产率为8.8%，而产科医生为13.6%，家庭医生为15.1%。认证助产士使用的资源少12.2%。产科医生和家庭医生的执业模式差异不大。
结论
华盛顿州认证助产士护理的低风险患者接受的产科干预比产科医生或家庭医生护理的类似患者少。这些差异与较低的剖宫产率和较少的资源使用有关。
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