广州市产科资源对新生儿窒息的影响

目的 :探讨广州市产科资源对新生儿窒息及重度窒息发生率的影响 ,总结进一步降低新生儿窒息发生率及重度窒息发生率的行政干预措施。方法 :对全市各产科医院的分娩量、产、儿科床位、 MICU、 NICU、产床数、产、儿科技术人才及设备资源等变量进行分层聚类分析 ,将特征相似的产、儿科资源合并 ,最终选择代表产科资源特征的 5类变量 ,将所有产科医院进行样品聚类。结果 :将 14 4所产科医院分 6类 ,描述各类医院特征 ,其中新生儿窒息及重度窒息发生率均最高的一类共 6所产科医院 ,其医院规模最小、技术力量不足、助产技术服务需求低。而新生儿窒息及重度窒息发生率均最低的一类共 6 3所产科医院 ,其产科资源与新生儿窒息发生率高的一组相似。结论 :要进一步降低广州市新生儿窒息发生率 ,可对重点医院进行技术指导 ,进行必要的医疗资源调整及投入。

Study on the influence of obstetrical resources on the incidences of neonatal asphyxia in Guangzhou

? Objective:To investigate whether the incidences of neonatal asphyxia and serious neonatal asphyxia were related to the distribution of health-care resource ,and to develop the further administrative intervention to control the incidence of neonatal asphyxia.Methods:18 concerned variables of obstetrical resources were put into Hierarchical cluster analysis and combined into 5 clusters.5 variables of 5 clusters,together with incidences of neonatal asphyxia and serious neonatal asphyxia of all 144 obstertrical departments were put into K-Means cluster analysis,6 new clusters of obstetrical departments had been gotten.Results:The category characterized by the highest incidences of neonatal asphyxia and severe neonatal asphyxia including 6 hospitals.Those hospitals had a smallest scale,a weak technical ability and a lower need for obstetric services.On the contrast,those had lowest incidences of neonatal asphyxia and severe neonatal asphyxia including 63 hospitals,they also had a small scale,a weak technical ability.Conclusion:Several further administrative interventions to control the incidences of neonatal asphyxia in Guangzhou are suggested as technical supports for problem hospitals and essential adjustments and investments in medical resoureces.