کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
953137 927568 2010 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Dramatic increase of Cesarean deliveries in the midst of health reforms in rural China
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
پیش نمایش صفحه اول مقاله
Dramatic increase of Cesarean deliveries in the midst of health reforms in rural China
چکیده انگلیسی

Cesarean delivery (CD) rates were until recently low in rural China where the population lacked health insurance. In July 2003 the New Cooperative Medical Scheme (NCMS) was introduced. We report findings from a health systems study carried out in the EC-funded project “Structural hinders to and promoters of good maternal care in rural China” in central and western China. The purpose was to analyze how CD rates changed with the increased level of funding of the NCMS.The research design was a natural experiment. Quantitative demographic, administrative and accounts data for 2001–2007 were collected in five counties from the county public health bureaux, the county NCMS offices, the county statistical offices and the Maternal and Child Health (MCH) hospitals, using a structured data collection form. We found that the CD rates increased in four of the five counties in the period 2004–2007 by 36%, 53%, 61% and 131% respectively. In the fifth county the CD rate remained high at 60%. The revenue from CD made up 72–85% of total delivery fee revenue. CD fee revenue increased by 97%, 239% and 408% in the three counties with available data; a higher increase than in general health care revenue. Our conclusion is that the design of NCMS, the provider payment systems, and the revenue-related bonus systems for doctors need to be studied to rein in the unhealthy increases in rural CD rates.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 70, Issue 10, May 2010, Pages 1544–1549
نویسندگان
, , , , ,