de Oliveira M I, Leal M do C
Programa de Assistência Integral à Saúde da Mulher, Criança e Adolescente da Secretaria de Estado de Saúde do Rio de Janeiro, Brasil.
Rev Saude Publica. 1997 Dec;31(6):572-80. doi: 10.1590/s0034-89101997000700005.
To disclose the existence of rooming-in (RI) in public and government contracted private hospitals that offer obstetric beds, in the State of Rio de Janeiro, Brazil, and to examine whether there is any association between RI and another quality care indicator which influences breastfeeding, namely the rate of cesarean section operations performed in these hospitals.
A survey was made of the existence of RI through a questionnaire sent to the Municipal Health Offices, the information collected being confirmed by telephone with each maternity hospital. The C-section rate data was obtained from the Rio de Janeiro State Health Office and divided into 2 groups: "below 40%" and "40% and above". The prevalence ratio was applied to the measurement of the association between the variables.
A rooming-in rate of 65.2% was found for the State as a whole, with regional variations: a better situation in the capital (84.8%), an intermediate one in the interior (69.9%), and a worse one in the metropolitan belt (44.2%). The public maternity hospitals revealed a higher rate (89.7%) than that of the government contracted private hospitals (53.3%). A direct relation between the practice of RI and low C-section rates was found in the hospitals. However, this association did not present the same weight in all regions of the State. The lowest proportion of hospitals adopting RI was verified in the metropolitan belt, whereas the highest relative number of hospitals with high C-section rates was observed in the interior.
It is concluded that to reverse the observed status, government authorities must fulfil their gerencial role within their own health system, as well as in the government contracted private hospitals.
揭示巴西里约热内卢州提供产科床位的公立及政府签约私立医院中母婴同室(RI)的存在情况,并探讨RI与另一个影响母乳喂养的优质护理指标(即这些医院的剖宫产手术率)之间是否存在关联。
通过向市卫生办公室发送问卷对RI的存在情况进行调查,并通过电话与每家产科医院确认所收集的信息。剖宫产率数据来自里约热内卢州卫生办公室,并分为两组:“低于40%”和“40%及以上”。采用患病率比来衡量变量之间的关联。
整个州的母婴同室率为65.2%,存在地区差异:首府情况较好(84.8%),内陆地区处于中等水平(69.9%),大都市带情况较差(44.2%)。公立产科医院的母婴同室率(89.7%)高于政府签约私立医院(53.3%)。在医院中发现RI做法与低剖宫产率之间存在直接关系。然而,这种关联在该州的所有地区并不具有相同的权重。在大都市带,采用RI的医院比例最低,而在内陆地区,剖宫产率高的医院相对数量最多。
得出的结论是,为扭转观察到的状况,政府当局必须在其自身卫生系统以及政府签约私立医院中履行其管理职责。