重庆市剖宫产的社会经济因素差异研究
Study on differences of socioeconomic factors influencing adoption of cesarean section in Chongqing

目的 分析重庆市剖宫产的社会经济影响因素。方法 采集2013年国家第5次卫生服务调查数据，经主成分分析法计算家庭财富值，采用集中指数及集中指数分解法测算剖宫产的社会经济因素不公平及影响因素对不公平的贡献程度。结果 调查的1 140名产妇中，有569人选择剖宫产，比例为49.91%。剖宫产率受社会经济因素的影响，主要因素包括农村户口（剖宫产率为45.06%，贡献率为－58.53%）、受教育程度为高中及以下（剖宫产率为44.12%，贡献率为38.76%）、参加城镇职工医疗保险（剖宫产率为58.93%，贡献率为26.49%）、生育1次（剖宫产率为55.13%，贡献率为23.38%）、年龄在25～29岁（剖宫产率为52.75%，贡献率为18.89%）。结论 社会经济因素对产妇生育方式的选择有一定影响。为了降低剖宫产率，相关部门应对目标人群进行妊娠、分娩相关知识的充分宣传和教育，帮助其选择最优的分娩方案；同时推广适宜的产科新技术，改善医疗环境并提高医疗质量；除此之外，还应加强行业自律，制定相关医疗卫生政策以降低我国剖宫产率。
： Objective To analyze socioeconomic factors that influence the adoption of cesarean section in Chongqing. Methods Data of the fifth national health service survey that conducted in 2013 were collected and household wealth was calculated by the principal component analysis. The concentration index and decomposition of concentration index were adopted to evaluate the inequality of socioeconomic factors that influence the adoption of cesarean section and contributions of influencing factors to the inequality. Results Among 1 140 puerperae, 569 of them (49.91%) chose the cesarean section. The rate of cesarean section was influenced by socioeconomic factors, which were rural registered permanent residence (the rate of cesarean section was 45.06% and the contribution rate was -58.53%), education level was or below the high school (the rate of cesarean section was 44.12% and the contribution rate was 38.76%), participation of medical insurance for urban workers (the rate of cesarean section was 58.93% and the contribution rate was 26.49%), primiparity (the rate of cesarean section was 55.13% and the contribution rate was 23.38%), and age between 25 and 29 (the rate of cesarean section was 52.75% and the contribution rate was 18.89%). Conclusion Socioeconomic factors have some effect on puerperae for choosing the delivery method. In order to decrease the rate of cesarean section, relevant institutions should enhance the propaganda and education of pregnancy and delivery for target populations; assist them to choose the best delivery method; promote appropriate new obstetric technologies; improve the medical environment and quality; strength self-discipline; and make relevant medical and health policies