外来孕妇保健服务利用及影响因素调研

目的:了解上海市外来孕妇对保健服务的利用情况和影响因素。方法:2009年6～7月对上海市19个区县的450名外来孕妇进行现状调查。结果:被调查孕妇中,86.00%已经建册,91.11%进行了产检,75.56%将来准备在二、三级医院分娩,72.89%准备在上海分娩。从影响因素看,影响孕期保健服务利用的主要有丈夫户籍、收入和医保,丈夫为上海户籍、家庭月收入高和享有医保的孕妇更愿意选择在上海和二、三级医院分娩;外来孕妇选择医院时首先考虑医疗质量(占68.56%),但"规范产检"受到经济收入的影响。研究显示,孕期保健服务的利用与孕妇年龄、妊娠史、孕妇本人及丈夫的文化程度无相关性。结论:目前上海市通过多种形式的健康教育和平价优惠政策推广,使得不同年龄、不同文化程度和生育经历的孕妇之间对孕产期服务利用差距逐渐缩小,但仍需进一步提高医疗质量,并加大保健服务的宣传力度,为外来人口提供更加安全、高质量、公平的保健服务。

Investigation and research on health services utilization and effect factors among the floating pregnant women

Objective:To understand the utilization of health services and effect factors among the floating pregnant women in Shanghai. Methods:A total of 450 floating pregnant women were selected from 19 districts(counties) of Shanghai city for field survey from June to July in 2009. Results:Among the pregnant women investigated,86.00% of them had registered in community health centers,91.11% of them had received antenatal examination,75.56% of them would like to give birth to babies in second-class and third-class hospitals,and 72.89% of them would like to give birth to babies in Shanghai.The main effect factors of maternal health services utilization included registered permanent residence of their husbands,income,and medical insurance;the pregnant women whose husbands had registered permanent residence of Shanghai city,with high family income and medical insurance preferred to give birth to babies in second-class and third-class hospitals;the first factor the pregnant women considered when they chose hospitals for delivery was medical quality(accounting for 68.56%),but "standard antenatal examination" was affected by economic income.The study showed that there was no correlation between maternal health services utilization and maternal age,pregnancy history,educational levels of the pregnant women and their husbands. Conclusion:At present,the publicity of health education in various forms and low-cost policy in Shanghai narrow the gap of maternal health utilization among the pregnant women of different ages,educational levels,and reproductive histories,but the medical quality should be improved further,the propaganda about health services should be strengthened to provide safe,high quality,and fair health services for the floating population.