CAJ | 학술논문

目的：分析广东省不同区域、不同级别医疗机构2005—2013年剖宫产率趋势并预测2014、2015年剖宫产率，为降低剖宫产率相关措施的制定提供参考依据。方法采用 Mann-Kendall 法对广东省2005—2013年剖宫产率进行趋势检验，采用二次指数平滑法预测2014、2015年剖宫产率。结果2005—2013年间，广东省各区域年剖宫产率总体均呈现出上升的趋势，经济发达地区年剖宫产率高于经济欠发达地区，医疗卫生机构级别越高，剖宫产率也越高。2005—2013年部队、省属医院年剖宫产率呈现出缓慢下降的趋势，部属医院存在很明显的上下波动趋势。地市、县区、乡镇级医疗机构年剖宫产率保持在一定范围内波动，地市级为42％～44％，县区级为32％～35％，乡镇级为17％～20％。2014、2015年剖宫产率预计比2012、2013年偏低，但波动不大。结论广东省年剖宫产率存在着地域别和医疗机构级别差异，降低剖宫产率不可忽视区域经济和医疗卫生系统水平差异的因素。建议实施降低剖宫产的相关制度，加强行政监管，提高社会对剖宫产的正确认识。
목적：분석광동성불동구역、불동급별의료궤구2005—2013년부궁산솔추세병예측2014、2015년부궁산솔，위강저부궁산솔상관조시적제정제공삼고의거。방법채용 Mann-Kendall 법대광동성2005—2013년부궁산솔진행추세검험，채용이차지수평활법예측2014、2015년부궁산솔。결과2005—2013년간，광동성각구역년부궁산솔총체균정현출상승적추세，경제발체지구년부궁산솔고우경제흠발체지구，의료위생궤구급별월고，부궁산솔야월고。2005—2013년부대、성속의원년부궁산솔정현출완만하강적추세，부속의원존재흔명현적상하파동추세。지시、현구、향진급의료궤구년부궁산솔보지재일정범위내파동，지시급위42％～44％，현구급위32％～35％，향진급위17％～20％。2014、2015년부궁산솔예계비2012、2013년편저，단파동불대。결론광동성년부궁산솔존재착지역별화의료궤구급별차이，강저부궁산솔불가홀시구역경제화의료위생계통수평차이적인소。건의실시강저부궁산적상관제도，가강행정감관，제고사회대부궁산적정학인식。
Objective To analyze the trend of cesarean section (CS)from 2005 to 201 3 in Guangdong Province and to predict the rates in 201 4 and 201 5. Methods Mann-Kendall method was used to analyze the trend and secondary exponential smoothing method was used to predict the CS rates in 201 4 and 201 5. Results There was a rising trend in CS rate in every region of Guangdong from 2005 to 201 3.The CS rates in the developed regions were higher than those in less developed regions.The CS rate was higher in higher level medical and health institutions.A downward trend was observed in military and provincial hospitals while the trend in affiliated hospitals showed obvious fluctuation and the rates in hospitals of municipal,county and town level maintained a smooth fluctuation range.The CS rate was 42% ~44% in municipal level hospitals,32% ~35% in county level hospitals and 1 7% ~20% in township level hospitals.Compared with the rates in 201 2 and 201 3,the predicted rates were a little bit lower and the fluctuation was not so obvious. Conclusion To reduce the already high CS rate,regional economy and medical and health system should be taken into consideration.Criteria for CS,administrative supervision and public education about CS should be part of the efforts in reducing CS rate in the province.