Adaptation and the limitations of evaluation method from the view point of micro economics in nursing

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We investigated 45 hospitals and got 291 samples of women in childbirth to evaluate nursing care from the viewpoint of micro economics. The subjects of our investigation was divided three of the women in childbirth, midwives and nursing administrator. The questionnaire was constructed with the factors related to past illness, a pregnancy period, delivery period, postpartum period, the cost (childbirth expenses and the hospital charges), hospital property and midwives autonomy. The goal of the analysis was to find out the factors to fix the price of childbirth expenses and the hospital charges. We used multi regression analysis. The dependent variable was the price and independent variables were 15 variables selected from above group.The results is follows.(l)Price decreasing factors were intervention of an obstetrician, use of monitoring devices, risk of an unborn child in delivery and weight increasing.(2)Price increasing factors were admission to hospital in pregnancy period and health education by midwife.(3)The level of midwives autonomy was low in hospitals.Followings are suggested.(1) Obstetricians tend to request health education to midwife in the cases of having problems.(2) Increasing of obstetrician intervention time, preparation of monitoring device and weight control are important for medical expenses control.(3) It is required for increasing the time of obstetrician intervention to set high level of midwives autonomy in a low risk case.