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目的:探讨影响丽水地区农村孕产妇住院分娩费用的因素,分析新型农村合作医疗和农村妇女住院分娩补助实施前后农村孕产妇住院分娩费用的变化。方法:对587例参合和接受农村孕产妇住院分娩补助的孕产妇进行回顾性调查分析。结果:剖宫产人均合作医疗报销和住院分娩补助2 438.78元,占总费用的42.37%;阴道产人均合作医疗报销和住院分娩补助1 136.87元,占总费用的40.01%。剖宫产分娩住院总费用是阴道产的2.03倍。医疗保健机构级别越高,分娩所需的费用越高。结论:新型农村合作医疗和农村孕产妇住院分娩补助的实施,有助于提高住院分娩率;控制剖宫产的比例,对于降低产妇住院分娩费用具有重大意义;丽水地区控制住院分娩费用的重点在区县级以上医疗保健机构。
OBJECTIVE: To explore the factors influencing the cost of hospital delivery in pregnant and lactating women in Lishui, and to analyze the changes of hospitalization and delivery costs of rural pregnant women before and after the implementation of new rural cooperative medical care and rural women’s delivery. Methods: A retrospective survey was conducted on 587 pregnant women participating and receiving subsidies for hospital delivery in rural areas. Results: Cesarean section per capita cooperative medical reimbursement and hospital delivery subsidy of 2 438.78 yuan, accounting for 42.37% of the total costs; per capita co-operative medical claims vaginal birth and hospital delivery subsidies of 1 136.87 yuan, accounting for 40.01% of the total costs. The total cost of cesarean section birth delivery is 2.03 times that of the vagina. The higher the level of the healthcare facility, the higher the cost of childbirth. Conclusion: The implementation of new-type rural cooperative medical care and rural maternity home delivery allowance can help increase hospital delivery rate. Controlling the proportion of cesarean section is of great significance to reduce maternal hospital delivery costs. The key point of Lishui area in controlling hospital delivery costs is District level above health care institutions.