CAJ | 학술논문

目的：本文通过对2009～2013年合肥市城镇职工生育保险现状的资料分析，探讨不同级别医疗机构分娩方式的构成及其成本差异。方法根据医疗机构的不同级别对2009～2013年合肥市参保城镇职工剖宫产与阴道分娩的生育住院费用、分娩方式进行比较分析。结果三级医院剖宫产及阴道分娩的住院费用高于一级、二级医院，二级医院剖宫产率呈上升趋势。自愿要求剖宫产率在不同级别医院中均呈上升趋势。结论建议加强医疗机构监管力度，进一步完善生育保险补偿政策。剖宫产率升高主要是孕产妇自愿要求增多所致，严格把握剖宫产指征是降低剖宫产率的关键。
목적：본문통과대2009～2013년합비시성진직공생육보험현상적자료분석，탐토불동급별의료궤구분면방식적구성급기성본차이。방법근거의료궤구적불동급별대2009～2013년합비시삼보성진직공부궁산여음도분면적생육주원비용、분면방식진행비교분석。결과삼급의원부궁산급음도분면적주원비용고우일급、이급의원，이급의원부궁산솔정상승추세。자원요구부궁산솔재불동급별의원중균정상승추세。결론건의가강의료궤구감관력도，진일보완선생육보험보상정책。부궁산솔승고주요시잉산부자원요구증다소치，엄격파악부궁산지정시강저부궁산솔적관건。
Objective To explore the composition and costs difference of delivery ways in medical institutions of different levels, based on the analysis of current maternity insurance situation for urban workers in Hefei from 2009 to 2013.Methods The inpatient expend-itures between delivery ways of cesarean section and vaginal delivery in medical institutions of different levels for urban workers with maternity insurance were compared and analyzed.Results In tertiary hospitals,the inpatient expenditures of both delivery ways were higher than those in first hospitals and secondary hospitals,and the cesarean section rate in secondary hospitals was on the rise.Increasing pregnant women choosing cesarean delivery in medical institutions of different levels might account for this change.Conclusion It is important to strengthen supervision over medical institutions of different levels,and to improve the compensation mechanism of maternity insurance.Because the in-crease of cesarean rate is mainly due to inadequately widening of medical indications in some maternity clinics,so the key point to reduce ce-sarean rate lies in how to rightly holding indications of cesarean section.