Assessing multidimensional care coverage for pre-eclampsia in the era of universal health coverage: A pre-post evaluation of the Salud Mesoamérica Initiative.
Assessing multidimensional care coverage for pre-eclampsia in the era of universal health coverage: A pre-post evaluation of the Salud Mesoamérica Initiative.
复制标题
评估全民健康覆盖时代先兆子痫的多维护理覆盖范围：对中美洲健康倡议的事前评估。
DOI：
10.1002/ijgo.13131
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Hernández,Bernardo
中科院分区：
文献类型：
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作者：
Kamath,ArunaM;Johanns,CaseyK;Thom,MaximillianG;Cogen,RebeccaM;Rios-Zertuche,Diego;Mokdad,AliH;Hernández,Bernardo
目的比较先兆子痫/子痫在中美洲卫生设施的多维护理包，之前和之后实施的Salud Mesoamérica Initiative.MethodsAn评价研究进行了67个基本和综合水平的卫生设施服务的最贫困地区在洪都拉斯，尼加拉瓜和伯利兹。随机抽取重度先兆子痫或子痫病例，并从2011年1月1日至2013年3月31日的基线（n=111）和2015年6月1日至2017年9月30日的第二阶段随访（n=249）的病历中提取相关护理质量数据。主要结果是证据的交付多维护理的管理先兆子痫/eclampsia.ResultsThe照顾360名妇女严重先兆子痫或子痫进行了分析。与基线相比，在第二阶段随访中，先兆子痫管理的多维护理的几率（P=0.271）增加（尽管不显著）。多维护理与培训（P<0.001），基本水平的设施（P<0.001），并在洪都拉斯（P=0.001）和伯利兹（P=0.024）高于参考国家尼加拉瓜。中美洲健康倡议是在全民健康覆盖时代实现这种高质量护理干预措施的一个有希望的模式。
ObjectiveTo compare a multidimensional care package for pre‐eclampsia/eclampsia in Central American health facilities, before and after implementation of the Salud Mesoamérica Initiative.MethodsAn evaluation study was conducted at 67 basic‐ and comprehensive‐level health facilities serving the poorest areas in Honduras, Nicaragua, and Belize. Cases of severe pre‐eclampsia or eclampsia were randomly sampled and relevant quality of care data extracted from medical records at baseline (n=111) from January 1, 2011, to March 31, 2013, and at second‐phase follow‐up (n=249) from June 1, 2015, to September 30, 2017. The primary outcome was evidence of the delivery of multidimensional care for the management of pre‐eclampsia/eclampsia.ResultsThe care of 360 women with severe pre‐eclampsia or eclampsia was analyzed. Odds of multidimensional care for pre‐eclampsia management (P=0.271) increased (although not significantly) in the second‐phase follow‐up compared to baseline. Multidimensional care was significantly associated with training (P<0.001), basic‐level facilities (P<0.001), and higher in Honduras (P=0.001) and Belize (P=0.024) than the reference country of Nicaragua.ConclusionMultidimensional care for pre‐eclampsia management increased across all facility types, countries, and severity of disease. The Salud Mesoamérica Initiative is a promising model for achieving such quality of care interventions in the era of universal health coverage.