| 引用本文：金曦,杜立燕,胡文玲,等.我国农村地区不同类型医疗卫生机构产科服务现状研究[J].中国卫生政策研究,2012,5(10):66-70 |
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| 我国农村地区不同类型医疗卫生机构产科服务现状研究 |
| 投稿时间：2012-07-04 修订日期：2012-07-17 PDF全文浏览 HTML全文浏览 |
| 金曦1, 杜立燕1, 胡文玲1, 汪金鹏1 |
| 中国疾病预防控制中心妇幼保健中心 |
| 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2 494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385%，县妇幼保健院占218%，基层医疗机构（乡镇卫生院和社区卫生服务中心）占317%。有350 %的助产机构不能提供基本产科服务，217%仅能够提供基本产科服务，仅432%的机构能够提供综合产科服务。仅60%左右的县级机构和146%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183%。孕产妇死亡以发生在基层医疗机构最高，占543%。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。 |
| 关键词:农村地区 医疗卫生机构 助产机构 产科 服务能力 |
| 基金项目:联合国儿童基金资助项目（YH702 H&N） |
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| Research on the current situation of maternity service in different medical health institutions in rural China |
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| Abstract: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, 385% of neonates is delivered in county general hospitals, 218% in county MCH hospitals， 317% 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, 217% of the institutions can only provide basic obstetric service, and 432% of the institutions is able to provide integrated obstetric service Only 60% county level hospitals and 146% grassroots level health care organizations can provide 24 hours six obstetric emergency service Among all midwifery complication cases，183% is in grassroots level health care organizations For maternal mortality in midwifery institutions, the highest is in grassroots level health care organizations, accounted for 543 % 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 |
| Key words:Rural area Medical health institutions Midwifery institutions Obstetric Service ability |
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