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目的探讨贵州省惠水县实施新农合和降消项目对孕产妇妊娠结局的影响。方法采用回顾性调查分析方法,基于惠水县医疗机构、户籍档案、新型农村合作医疗(新农合)工作组、降低孕产妇死亡率和消除新生儿破伤风项目(降消)工作小组工作成果报告,对数据进行统计分析。结果未开展项目(1996-1999年)、降消项目开展中(2000-2003年)、新农合联合降消项目开展中(2004-2007年),孕妇死亡率、住院分娩率、新生儿破伤风率、新法接生率、高危孕妇住院分娩率、产检覆盖率显著提高,差异具有统计学意义(P<0.05);开展降消项目后农村住院分娩率、农村低保家庭产妇产检率显著提高,差异具有统计学意义(P<0.05);开展新农合后,农村住院生产率显著提高,农村城镇产检覆盖、住院分娩率均显著提高,差异具有统计学意义(P<0.05)。结论降消项目执行后,惠水县孕产妇接受医疗保健情况显著好转,孕产妇死亡率及新生儿破伤风率显著降低,农村低保家庭产妇产检率改善效果显著;新农合开展后,农村产妇住院分娩率显著提高,但城镇低保家庭孕产妇其产检率未见显著提高;惠水县两项医疗制度成效显著,但惠及城镇低保家庭不足,应予以重视;新农合政策与降消项目存在一定重叠,新农合执行后,接受降消产妇比例显著下降,两个项目同时开展效果显著。
Objective To explore the impact of the implementation of the new rural cooperative medical system and the project of reduction and elimination on the pregnancy outcome of pregnant women in Huishui County, Guizhou Province. Methods The retrospective investigation and analysis methods were used in the work team of the working group on reducing maternal mortality and eliminating neonatal tetanus due to the medical institutions in Huishui County, household registration files and the New Rural Cooperative Medical Care (NCMS) Working Group Report, the data for statistical analysis. Results Undeveloped projects (1996-1999), cancellation of projects underway (2000-2003), new rural cooperative medical projects (2004-2007), maternal mortality, hospital delivery rate, neonatal breakthrough The rate of hospitalization, the delivery rate of newborns, hospital delivery rate of high-risk pregnant women and the coverage rate of birth control were significantly increased (P <0.05). After the cancellation project was canceled, the hospital delivery rate in rural areas was significantly increased, The difference was statistically significant (P <0.05). After the new rural cooperative medical system was implemented, the hospitalization rate in rural areas was significantly increased. The inspection coverage and hospital delivery rate in rural areas were significantly increased (P <0.05). Conclusion After the implementation of the cancellation project, the situation of maternal health care in Huishui County has been significantly improved, the maternal mortality rate and the neonatal tetanus rate have been significantly reduced, and the detection rate of maternity rate in rural residents with low-income families has been significantly improved. After the implementation of NCMS, Maternity hospital delivery rate increased significantly, but the rate of maternity of urban residents with minimal needs no significant increase in the detection rate; Huishui two medical system achieved remarkable results, but the lack of benefits to urban families, should be taken seriously; new rural cooperative medical policy and After the implementation of NCMS, the proportion of women receiving downgrading decreased significantly, and the two projects carried out the same effect at the same time.