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目的全面了解广东省助产技术服务资源现状,为优化资源配置、助产机构分级管理和有效应对全面二孩政策实施提供依据。方法调查广东省内所有助产机构类别、助产技术服务级别、产科床位、人力资源及分娩量等情况,分析不同区域、类别和层级机构的资源配置及服务能力现状。结果助产技术服务资源分布不均衡,每千常住人口产科床位数0.42张,医护比1∶1.1,助产技术服务能力自评为一级、二级和三级的分别有1078家(56.7%)、587家(30.9%)和164家(8.6%),未达到一级标准的有73家(3.8%),随着级别的上升每千分娩量医师和护士数下降,医护比在上升;一级和二级助产机构应对分娩量上升的空间较大。结论助产技术服务资源分布不均、不足与过剩并存,应加强对一、二级助产机构的政策支持和财政投入,切实促进分级诊疗的落地,系统提升应对全面二孩政策的能力。
Objective To comprehensively understand the current status of midwifery technical service resources in Guangdong Province and provide the basis for optimizing the allocation of resources, grading management of midwifery institutions and effectively coping with the implementation of the all-round two-child policy. Methods To investigate the types of midwifery institutions, midwifery technical service levels, maternity beds, human resources and delivery volume in Guangdong Province, and to analyze the current situation of resource allocation and service capabilities in different regions, categories and levels. Results The distribution of midwifery technical service resources was unbalanced. The number of obstetric beds per thousand population was 0.42 and the ratio of health care to care was 1: 1.1. The midwifery technical service capacity was rated as first grade, while the second and third grade were 1078 (56.7% ), 587 (30.9%) and 164 (8.6%), while 73 (3.8%) did not meet the first-tier standard. As the level increased, the number of physicians and nurses per millimeter decreased and the health-care ratio was on the rise; Primary and secondary midwifery should have more room to respond to the increase in delivery. Conclusions The resources of midwifery technical service are distributed unevenly, and the insufficiency and surplus coexist. We should strengthen the policy support and financial investment for primary and secondary midwifery, effectively promote the grading of medical treatment and treatment and systematically improve the ability to cope with the comprehensive two-child policy.