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目的比较基本公共卫生服务项目配套政策实施前后,上海市浦东新区孕产妇保健服务利用的改善程度,提出相应政策建议。方法采用前后2次横断面回顾性调查的方式,对主要在上海市浦东新区接受孕产保健服务的婴儿母亲进行问卷调查,比较基本孕产保健服务利用率和服务满意度等指标的差异。结果配套政策实施后,孕产保健服务利用大部分指标有所上升;政策实施前后,非本市户籍孕产妇孕期产前检查率、5次及以上产前检查率、9次及以上产前检查率差异有统计学意义(χ~2=5.10、4.20、5.02,均P<0.05);Logistic回归模型分析显示,免费政策实施后,孕期9次及以上产前检查率高于政策实施前(OR=1.445,P<0.05);服务利用者对产后访视服务综合满意度及收费方面、服务态度、服务内容、医患交流等4个服务指标满意度均有提高,差异均有统计学意义(t=-5.62、-6.83、-4.38、-5.05、-4.91,均P<0.01)。结论基本公共卫生服务减免政策有助于改善孕产保健服务利用率及满意度,对于促进均等化也有一定效果。
Objective To compare the improvement of utilization of maternal health services in Shanghai Pudong New Area before and after the implementation of supporting policies for basic public health services and put forward corresponding policy suggestions. Methods The cross-sectional retrospective survey was conducted before and after the two-way retrospective survey to survey the mothers who received maternal health services mainly in Pudong New Area in Shanghai. The differences in the utilization rates of basic maternal health services and service satisfaction were compared. Results Before and after the implementation of the supporting policies, most of the indicators for the utilization of maternal health care services increased. Before and after the implementation of the policy, the prenatal checkup rates of pregnant women during pregnancy, the prenatal checkup rates of 5 or more and the prenatal checkups of 9 and above (Χ ~ 2 = 5.10,4.20,5.02, all P <0.05). Logistic regression analysis showed that the rate of prenatal check-up 9 times or more during pregnancy was higher than that before the policy implementation (OR = 1.445, P <0.05). Satisfaction of service users with four service indicators such as service satisfaction, service content, doctor-patient communication and so on were all improved significantly t = -5.62, -6.83, -4.38, -5.05, -4.91, all P <0.01). Conclusion The basic public health service relief policy helps to improve the utilization and satisfaction of maternal health services and has some effect on promoting equalization.