摘要
目的:调查农村地区医疗卫生机构产科服务提供及服务能力,了解不同类别助产机构服务特点、优势,发现存在的问题。方法:在全国随机抽取44个地市,对44个地市全部助产服务机构(3021所)2008—2010年产科服务情况进行问卷调查,本文仅对农村地区(县和县级市)助产机构进行分析。结果:共调查了2494所机构。在全部助产机构分娩的新生儿中,县级综合性医院占38.5%,县妇幼保健院占21.8%,基层医疗机构(乡镇卫生院和社区卫生服务中心)占31.7%。有35.0%的助产机构不能提供基本产科服务,21.7%仅能够提供基本产科服务,仅43.2%的机构能够提供综合产科服务。仅60%左右的县级机构和14.6%的基层医疗机构能24小时提供6种产科相关急救服务。全部产科合并症及并发症病例中,在基层医疗机构就诊的占18.3%。孕产妇死亡以发生在基层医疗机构最高,占54.3%。结论:县级综合性医院和县妇幼保健院是农村地区助产服务的主要力量。农村地区助产机构产科服务能力还有待提高。应当加强对基层助产机构的管理,杜绝其超范围执业。明确各类助产机构功能定位,加强机构之间协作,建立农村地区孕产妇急救转诊网络。
Objective：To investigate obstetric service provision and service ability of medical institutions in rural China, to understand character and superiority of difference kind midwifery institutions and to find problems in obstetric service. Methods： 44 cities were randomly Sampled nationwide, Questionnaire survey collected information on the situation of obstetric service of all midwifery institutions in 44 cities from 2008 to 2010. In total 3021 institutions were investigated, this article only analysis midwifery institutions in rural area. Results： In total 2494 midwifery institutions were investigated. Among all neonates delivery in midwifery institutions, 38.5% of neonates is delivered in county general hospitals, 21.8% in county MCH hospitals, 31.7% in grassroots level health care organizations （ town hospitals and community health service centers） respectively. Among all midwifery institutions, 35 % of the institutions can not provide the basic obstetric service, 21.7% of the institutions can only provide basic obstetric service, and 43.2% of the institutions is able to provide integrated obstetric service. Only 60% county-level hospitals and 14. 6% grassroots level health care organizations can provide 24 hours six obstetric emergency service. Among all midwifery complication cases, 18.3 % is in grassroots level health care organizations. For maternal mortality in midwifery institutions, the highest is in grassroots level health care organizations, accounted for 54. 3 %. Conclusion：County general hospitals and county MCH hospitals are main source of obstetric service provision. Midwifery institutions obstetric service ability in rural area needs to be reinforced. The health administrative department should improve management on grassroots level health care organizations and ban it practice beyond, clear function orientation of different midwifery institutions, establish good cooperation relationship among different midwifery institutions, and build referral network for pregnant women emergency service.
出处
《中国卫生政策研究》
2012年第10期66-70,共5页
Chinese Journal of Health Policy
基金
联合国儿童基金资助项目(YH702H&N)
关键词
农村地区
医疗卫生机构
助产机构
产科
服务能力
Rural area
Medical health institutions
Midwifery institutions
Obstetric
Service ability
