| Objectives1. To master the situation and the changing trend of obstetric beds allocation and utilization in rural areas, and to evaluate the bed balance situation of supply and demand.2. To understand the equity in obstetric beds allocation in rural areas.3.To find out the problems in obstetric beds allocation through typical region investigation, to explore the ways of rationally allocation and fully utilization of obstetric beds, and to provide theoretical evidence for policy-making and strategy of obstetric beds rational allocation in rural areas.Methods1. Using Descriptive analysis to analyze the situation and the changing trend of obstetric beds allocation and utilization.2. Evaluating the bed balance situation by evaluation of supply-demand balance.3. Lorenz curve and Gini coefficient were used to measure the equity of obstetric beds resources in rural areas.4. Choose two counties which with great population moving in east areas and poverty counties in remote west areas to conduct typical region investigation. Through interviewing with health administration officers and medical personnel to know the local hospitalized delivery policies and implementation, to understand the status of obstetric service supply and utilization, and to master the impact factors of obstetric beds utilization. Sort and analyze the interview results by Thematic FrameworkResults1. The quantitative results:(1) Obstetric beds resources were unevenly distributed in different rural regions. The obstetric beds per1000populations were0.23in national level, this rate in central areas (0.25beds) was higher than that in western (0.21beds) and eastern (0.23beds) areas; the obstetric beds per square kilometer were0.05in national level, this rate in eastern areas (0.09beds) was higher than that in western (0.02beds) and central (0.07beds) areas.(2) As for the proportion of obstetric beds in rural areas, grassroots level health care organizations was the highest (38.2%), followed by county general hospitals (35.1%). From2008to2010, the number of obstetric beds kept growing.(3) During2008-2010, the percentage of hospital deliveries increased in different regions, and this rate grew fastest in western areas.(4) Obstetric beds utilization rate was highest in county general hospitals, while the obstetric beds utilization was inadequate in grassroots level health care institutions.(5) The obstetric beds resources allocation was equitable when measured by the layout of population (Gini coefficient0.22), which was inequitable when measured by geographic distribution (Gini coefficient0.58).2. Typical region investigation results:Under the influence of many factors (policy, economy, population mobility, transportation, geographical environment, health care awareness and custom), the demands of hospital delivery service moved up to the high level medical institutions, which led to the obstetric beds in county general hospitals got more tension, but hospital delivery service was shrinking in grassroots level health care organizations. Hospital delivery was a prominent problem among pregnant women in remote areas and floating population.ConclusionsThe scales of obstetric beds in different areas with different economic level developed unbalancedly, and the geographic equity of obstetric beds distribution needs to be improved. Hospital delivery rate showed an ascending trend in rural areas, and the demands of hospital delivery service move up to high level medical institutions. The obstetric beds in county general hospitals got more tension, while hospital delivery service was shrinking in grassroots level health care organizations. The obstetric beds resource was still unable to effectively cover marginal and vulnerable population. Obstetric beds resources in rural areas should be regulated.Suggestions1. Allocate the obstetric beds resources in different regions rationally according to their local demands.The health administrative departments should appropriately adjust obstetric beds quantity distribution in the midwifery institution of county and town level, and strengthen obstetric beds in the midwifery institution of county level.2. The health administrative departments should clear and definite function orientation of different midwifery institutions, and establish good relationship between different midwifery institutions.3. Solve major and difficult problems of obstetric beds in rural areas through project implementation, and through widely advocating and implementing successful projects.4. Carry out health education to promote hospital delivery among pregnant women in remote areas and floating population, and increase obstetric beds utilization rate in rural areas. |
