Socioeconomic inequalities in hospital births in China between 1988 and 2008
Socioeconomic inequalities in hospital births in China between 1988 and 2008
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DOI：
10.2471/blt.10.085274
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发表时间：
2011-06-01
影响因子：
11.1
通讯作者：
Ronsmans, Carine
中科院分区：
文献类型：
--
作者：
Feng, Xing Lin;Xu, Ling;Ronsmans, Carine
目的评估1988-2008年中国住院分娩的趋势，以确定克服住院分娩的经济障碍的努力是否缩小了贫富之间的获得差距。方法采用四项全国卫生服务调查的横断面数据来确定1988-2008年住院分娩的趋势。通过泊松回归计算粗利率和调整后的年利率，并用于定义不同社会经济区域和不同收入五分位数家庭的趋势。2008年，除了四区（最偏远的农村地区），中国几乎所有妇女都在医院分娩，该地区住院分娩的比例仅为60.8%。在2002年之前，该地区的住院分娩稳步增加，但在2002年之后，上升趋势放缓。在1988-2001年期间，年平均增长率为21%，但在2002-2008年下降到10% （P=0.0031）。社会经济区域之间的不平等大于属于不同收入阶层的单个家庭之间的不平等。到2008年，低收入和高收入家庭在住院分娩比例上的差异已经变得非常小（当年，高收入和低收入家庭在医院分娩的比例分别为96.1%和87.7%）。结论大多数中国妇女现在在医院分娩，但最贫困的农村地区仍然落后。需要采取更加积极和全面的办法，以增加这些偏远、难以到达的人口的住院分娩。
Objective To assess, trends in hospital births in China during 1988-2008 in an effort to determine if efforts to overcome financial barriers to giving birth in hospital have reduced the access gap between the rich and the poor.Methods Cross-sectional data obtained from four National Health Service Surveys were used to determine trends in hospital births during 1988-2008. Crude and adjusted annual rates were calculated by means of Poisson regression and were used to define trends across socioeconomic regions and households in different income quintiles.Findings In 2008 women throughout China were giving birth in hospital almost universally except in region IV, the most remote rural region, where the percentage of hospital births was only 60.8. Hospital births in this region had increased steadily before 2002, but after that year the upward trend slowed down. During 1988-2001 the average yearly increase had been 21%, but in 2002-2008 it dropped to 10% (P=0.0031). Inequalities between socioeconomic regions were greater than among individual households belonging to different income strata. By 2008 the difference between low- and high-income households in the proportion of hospital births had become very small (96.1% and 87.7% of high- and low-income households, respectively, gave birth in hospital that year).Conclusion Most Chinese women now give birth in hospital, but the poorest rural region is still lagging behind. A more active and comprehensive approach will be needed to increase hospital births in these remote, hard-to-reach populations.