二孩产妇生育政策相关分娩情况及住院费用分析  

Analysis of delivery situation and hospitalization expenses related to birth policy of two-child puerpera

作　　者：徐梦秋[1] 丁丽萍[1] Xu Mengqiu;Ding Liping(Department of Medical Records and Statistics, Zhejiang Provincial People′s Hospital (People's Hospital of Hangzhou Medical College), Hangzhou 310014, China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)病案与统计科,浙江杭州310014

出　　处：《中国医院统计》2021年第2期157-161,共5页Chinese Journal of Hospital Statistics

摘　　要：目的分析某院二孩产妇的分娩情况和住院费用的影响因素。方法在住院病案首页中筛选2006年2月至2020年8月,2次均在某院住院分娩的产妇共2474名,形成研究样本4948份。描述产妇的基本情况,主要诊断的构成比及顺位。运用2组独立样本t检验比较阴道分娩和剖宫产产妇的分娩年龄、住院天数、住院费用。运用多因素线性回归分析,筛选住院费用的影响因素。结果二产产妇人数2014年同比增长123.53%,2016年同比增长109.36%,2016年以后趋于稳定。阴道分娩总人次(n_(1)=2780)多于剖宫产分娩总人次(n_(2)=2168),阴道分娩产妇的平均分娩年龄、平均住院日、住院次均费用均小于剖宫产产妇,差异均有统计学意义。住院费用的多因素回归分析,自变量分娩年龄、分娩方式、“单独二孩”政策、“全面二孩”政策、住院天数、合并症并发症,进入回归方程(F=2926.669,P<0.001,R^(2)=0.784)。结论二孩政策推动了二孩生育的高峰期,2016年之后进入平稳期。分娩年龄、住院费用逐渐增加,分娩年龄差增大,住院天数逐渐减少。阴道分娩的二产产妇比一产产妇头位顺产比例减少,妊娠期糖尿病比例增加。剖宫产分娩的一产产妇主要诊断最多的是选择性剖宫分娩,二产产妇主要诊断最多的是妊娠合并子宫瘢痕。分娩年龄,分娩方式,生育政策环境,住院天数,合并症并发症是产妇住院费用的独立影响因素。Objective To analyze the delivery and hospitalization expenses of two-child puerpera in a hospital.Methods From February 2006 to August 2020,2474 puerpera were selected from the first page of inpatient medical records,and 4948 research samples were formed.The basic situation of puerpera were described,as well as constituent ratios and rank of the major diagnoses.The t-test of two groups of independent samples was used to compare the age of delivery,length of stay and hospitalization expenses of women with vaginal delivery and cesarean section.The influence factors of hospitalization expense were screened with multivariate linear regression analysis.Results The year-on-year growth rate of two-child puerpera was 123.53%in 2014,109.36%in 2016,and stabilized after 2016.The total number of vaginal delivery women(n_(1)=2780)was higher than that of caesarean delivery women(n_(2)=2168).The average age of delivery,average length of stay and average expenses of hospitalization of the vaginal delivery group were all lower than those of the caesarean delivery group,and the differences were statistically significant.In multivariate regression analysis of hospitalization expenses,age of delivery,delivery mode,policy of"single two-child",policy of"universal two-child",hospitalization days,comorbidities and complications entered into the regression equation(F=2926.669,P<0.001,R^(2)=0.784).Conclusion The two-child policy has promoted the peak period of two-child births,which entered a stable period after 2016.The age of childbirth and the cost of hospitalization gradually increased,the age difference of childbirth increased,and the length of stay gradually decreased.In the vaginal delivery group,the proportion of spontaneous vertex delivery of women giving birth to the second child was lower than that of women giving birth to the first child,but the proportion of gestational diabetes was higher.In the cesarean delivery group,the first major diagnosis of women giving birth to the first child was selective caesarean birth,but the f

关 键 词：二孩 分娩 生育政策 住院费用 影响因素 

分 类 号：R197.32[医药卫生—卫生事业管理]