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Applying the Ecology Model to Perinatal Medicine From a Regional Population-Based Study英文文献资料.doc

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Applying the Ecology Model to Perinatal Medicine From a Regional Population-Based Study英文文献资料

HindawiPublishingCorporation JournalofPregnancy Volume2011,ArticleID587390,4pages doi:10.1155/2011/587390 ClinicalStudy ApplyingtheEcologyModeltoPerinatalMedicine: FromaRegionalPopulation-BasedStudy SyuichiTokunaga,HiroshiSameshima,andTsuyomuIkenoue DepartmentofObstetricsandGynecology,FacultyofMedicine,UniversityofMiyazaki,5200Kihara,Kiyotake, Miyazaki889-1692,Japan CorrespondenceshouldbeaddressedtoHiroshiSameshima,hsameshima@fc.miyazaki-u.ac.jp Received6April2011;Revised28May2011;Accepted28May2011 AcademicEditor:DavidF.Lewis Copyright?2011SyuichiTokunagaetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Objective.Ecologymodelisusefultoprovideaframeworkfororganizingmedicalcare.Weaimedtoseeiftheecologymodel isapplicabletoperinatalcareinJapan.Methods.Onapopulation-basedapproach,wehad53,461deliveriesinMiyazakifrom 2001to2005.Incomparison,weusedallofthe106,613deliveriesinTokyoin2009.Womenweredividedinto4gradesbyrisk- allocationcriteriaandtheirproportionwasexpressedper1,000womentoapplytothemodelandtodelineatetheecologycurve. TheperinatalmortalitywascomparedbyChi-squaretest.Results.Wefoundremarkablesimilarityinecologycurvesbetween theoriginalecologymodelsandthatrepresentingMiyazakiperinataldata.However,thecurverepresentingTokyowasdi?erent fromtheoriginalone.Besides,theperinatalmortalitywassigni?cantlylowerinMiyazaki(4.40/1,000)thaninTokyo(5.06/1,000). Conclusion.Applyingtheecologymodeltoperinatalcareisusefulwithimprovementofperinataloutcomeanditwouldprovide anappropriateframeworkfororganizingperinatalcare. 1.Introduction healthcareseekingbehaviorofpeoplewiththeactualhealth serviceutilization. Theecologymodelofmedicalcarewas?rstintroducedin 1961 [1]. In this original model concerning 1,000 adults at risk, 750 of these individuals feel sick, 250 consult a physician, 15 require specialized care, and 1 needs to be referr