Ambulance Service Associated With Reduced Probabilities Of Neonatal And Infant Mortality In Two Indian States
Ambulance Service Associated With Reduced Probabilities Of Neonatal And Infant Mortality In Two Indian States
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DOI：
10.1377/hlthaff.2016.0564
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发表时间：
2016-10-01
期刊：
影响因子：
9.7
通讯作者：
Miller, Grant
中科院分区：
文献类型：
--
作者：
Babiarz, Kimberly S.;Mahadevan, Swaminatha V.;Miller, Grant
印度在2005年之前没有大规模的中央紧急医疗系统或救护车服务。从那时起，GVK应急管理和研究所（GVK EMRI）已成为印度最大的救护车服务提供商，覆盖超过6.3亿人。这项研究提供了GVK EMRI对安得拉邦和古吉拉特邦人口水平婴儿和孕产妇健康结果的早期影响的第一个定量证据，这两个印度邦的总人口约为1.45亿人。我们发现，GVK EMRI覆盖率与新生儿和婴儿死亡率以及分娩并发症的概率降低有关（安得拉邦全州和古吉拉特邦的高死亡率地区）。然而，我们发现机构分娩或熟练助产的概率几乎没有变化。总的来说，我们的研究结果表明，人口水平的健康收益是通过改善孕产妇和新生儿健康服务的质量（而不是数量）实现的，这一解释与定性报告一致。需要对这一主题进行更多的研究。
India had no large-scale, centralized emergency medical system or ambulance service until 2005. Since then, the GVK Emergency Management and Research Institute (GVK EMRI) has emerged as India's largest ambulance service provider, covering more than 630 million people. This study provides the first quantitative evidence of GVK EMRI's early impact on population-level infant and maternal health outcomes in Andhra Pradesh and Gujarat, two Indian states with a combined population of about 145 million people. We found that GVK EMRI coverage is associated with reductions in the probability of neonatal and infant mortality as well as delivery complications (statewide in Andhra Pradesh and in high-mortality districts in Gujarat). However, we found little change in the probability of institutional delivery or skilled birth attendance. Taken together, our findings suggest that population-level health gains were achieved through improvements in the quality (rather than quantity) of maternal and neonatal health services-an interpretation consistent with qualitative reports. More research on this topic is needed.