中国9193名妇女孕早期保健经济负担现状分析

目的了解我国孕妇孕期保健的经济负担现状,探究不同地区和人群孕期保健服务的可及性和公平性。方法对中国孕产妇队列研究·协和项目在2017年7月25日至2018年11月26日招募的孕早期妇女,共9193例,进行一般情况和孕期保健经济负担的调查,采用SPSS 25.0软件进行统计分析。结果孕妇产检直接医疗费用中位数为400元/次,误工费用中位数为360元/次。分析结果显示,孕前BMI<18.5kg/m 2的孕妇直接医疗费用最高(P=0.008);城镇高于农村(P<0.001);家庭成员越少直接医疗费用越高(P<0.001,P trend=0.003);社会经济地位越高直接医疗费用也越高(P<0.001,P trend=0.003),而误工费越低(P=0.025,P trend=0.017);东部孕妇的直接医疗费用最高(P<0.001);北方孕妇的直接医疗费用(P=0.002)、误工费用均高于南方(P=0.013)。此外,孕早期保健直接医疗费用占家庭年收入的比例随家庭年收入的增加呈下降趋势。结论我国孕期保健服务的可及性和公平性问题依然存在。建议相关部门进一步完善孕产保健服务、构建多元化医疗保健服务体系,以保障孕产妇健康,促进优生优育。

Analysis on the economic burden of maternal health care of 9193 women during early pregnancy in China

Objective To understand the status of economic burden of maternal health care of pregnant women in China,and to discuss the equity and accessibility of maternal health care during pregnancy among different regions and populations.Methods A total of 9193 women during early pregnancy were recruited from the Chinese Pregnant Women Cohort Study between July 25,2017 and November 26,2018.Information on general condition and economic burden of maternal health care was surveyed.SPSS 25.0 software was used for statistical analysis.Results The median direct medical cost of maternity check-ups for pregnant women was 400 CNY per visit,and the median cost of lost work was 360 CNY per visit.The analysis of the results showed that the median medical expense was highest in pre-pregnant women with BMI<18.5kg/m 2(P=0.008).The median medical expense was higher in urban residents than rural residents(P<0.001).Families with fewer members had higher direct medical expenses(P<0.001,P trend=0.003).The higher the socioeconomic status was,the higher the direct medical expense was(P<0.001,P trend=0.003).The cost of lost work was lower in pregnant women with higher socioeconomic status(P=0.025,P trend=0.017).In addition,the medical expense was highest in women living in the eastern part of China(P<0.001).The direct medical expenses(P=0.002)and lost-time expenses of pregnant women in the North were higher than those in the South(P=0.013).Conclusion The problem of equity and accessibility of maternal health care still existed.It is recommended that relevant departments further improve maternal health care services and build a diversified healthcare service system to ensure maternal and child health and promote eugenics.