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目的了解广西各级助产机构产科基本情况,为“十二五”期间广西产科设置规划提供科学依据。方法对2011年广西各级助产机构进行产科基本情况和人力资源调查。结果 2011年全区助产机构1 498家的调查结果显示,产科在编人员仅占54.6%,不同类别医院的人员编制构成存在差异(P<0.01),在编比例最高的是乡镇卫生院占62.4%,在不同级别的妇幼保健院、同一级别的县级机构中县级妇幼保健院在编比例最低为38.4%。乡镇卫生院初级职称、无职称的比例最多,分别是60.0%、20.7%,职称总体构成有差异(P<0.01)。产科医师的总体服务率为114.8,其中最高的综合医院达172.7,最低的乡镇卫生院仅81.1,各类医院服务率总体存在差异(P<0.01)。产科床位与产科医护人员比为1∶0.91,医护各类医院产科床位与人员比总体有差异(P<0.01),妇幼保健院最高为1∶1.11,乡镇卫生院为1∶0.80。2011年全区助产士平均接产数220人,乡镇卫生院最多达336人,县级机构中妇幼保健院助产士接产最多平均为257人。结论县级妇幼保健院产科人员严重缺编,产科人员超负荷工作。乡镇卫生院服务能力差,加强乡镇卫生院的人才培养,提高服务能力和服务质量,保障农村孕产妇的母婴安全。
Objective To understand the basic conditions of obstetrics and gynecology in all levels of Guangxi and provide a scientific basis for the establishment of obstetrics and gynecology in Guangxi in the 12th Five-year Plan period. Methods The basic conditions of obstetrics and human resources survey of all levels of midwives in Guangxi in 2011 were investigated. Results The survey results of 1 498 midwifery institutions in 2011 showed that obstetricians only accounted for 54.6% of the staffs, and there were differences in the staffing structure among different categories of hospitals (P <0.01) 62.4%. In different levels of MCH and county-level MCH institutions at the same level, the minimum proportion in MCHR is 38.4%. Township hospitals, junior titles, the highest proportion of non-title, respectively, 60.0%, 20.7%, the overall composition of job titles are different (P <0.01). The overall service rate of obstetricians was 114.8, of which the highest general hospital reached 172.7 and the lowest township hospital was only 81.1. There was a general difference in the service rate among various hospitals (P <0.01). Maternity beds and obstetric medical staff ratio of 1: 0.91, hospital beds and staff of all types of hospital health care than the overall difference (P <0.01), the highest MCH 1: 1.11, township hospitals 1: 0 80. 2011 District midwives take an average of 220 people, township hospitals up to 336 people, county-level institutions in MCH midwife up to an average of 257 people. Conclusions Maternity and child care hospitals at county level are seriously lacking in obstetrics and gynecology and obstetricians are overworked. Poor service capacity of township hospitals, township hospitals to strengthen personnel training, improve service capabilities and service quality, protection of maternal and child maternal and child safety in rural areas.