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目的:构建能够综合反映产前保健服务利用的指标,并通过实际应用研究该指标对产时和产后保健的预测意义。方法:根据国外已有的综合性产前保健服务利用指标和中国卫生部对产前保健服务的有关规定,构建适合中国农村具体情况的综合性产前保健服务利用指标,即产前服务利用适宜指数,并利用秦巴卫生项目终末家庭调查资料,应用该指标分析产前服务利用水平对产时和产后保健的影响。结果:根据产前服务利用适宜指数分类,与产前服务利用不足的孕产妇相比,产前服务利用中等、足够和充裕的孕产妇住院分娩的OR值分别为1.378,2.488和3.216,差异均有统计学意义;与产前服务利用不足的孕产妇相比,产前服务利用中等、足够和充裕的孕产妇产后访视的次数平均分别要多0.33次,0.65次和0.72次,差异也均有统计学意义。结论:产前服务利用适宜指数可以综合反映产前的服务利用,该指标比较简单并能够预测产时和产后保健服务利用,可以有效应用于孕产期服务利用评估。
OBJECTIVE: To construct an index that can comprehensively reflect the utilization of prenatal health care and to study the predictive value of this index on the birth and postpartum health care through practical application. Methods: According to the existing comprehensive prenatal care service utilization indicators and the relevant provisions of the Chinese Ministry of Health on prenatal health care services, we constructed a comprehensive prenatal care service utilization index that is appropriate to the specific conditions in rural China, that is, the prenatal service utilization is appropriate Index, and using the Qinba health project terminal family survey data, the use of indicators to analyze the impact of prenatal service utilization on delivery and postnatal care. Results: According to the index of prenatal services using appropriate index, the OR of prenatal services with moderate, adequate and sufficient maternal hospital delivery were 1.378, 2.488 and 3.216, respectively, compared with that of maternal prenatal services The average number of postpartum visits of pregnant women with moderate, sufficient and sufficient prenatal services was 0.33 times, 0.65 times and 0.72 times on average, respectively, as compared with that of maternal prenatal services There is statistical significance. Conclusion: The prenatal service utilization index can comprehensively reflect the utilization of prenatal services. The index is relatively simple and can predict the utilization of health services during delivery and postnatal period, which can be effectively used in the assessment of service utilization during pregnancy and childbirth.