本研究之目的有二，(一)建立一個新的產科健康照顧模式。此模式包含兩個重點:(1) 由助產護理師及產科醫師共同管理產婦之生產(midwife-obstetrician co-managed service)，(2)LDR(labor/delivery/recovery)program—即是產婦待產、生產、產後恢復及 照顧均安排在同一個房間，且由相同之助產護理人員來照顧。(二)評量此健康照顧模式之效 益，效益之指標為:(1)剖腹生產之機率，(2)生產醫療費用，(3)顧客滿意度。在建立新產科 健康照顧模式方面，主要是參考國內外資料並利用樣本醫院中的資源，在評量方面則採二組 對照比較方式進行。170位符合選樣條件的孕產婦，以自選方式納入傳統產科健康照顧組(151 人)或新產科健康照顧組(19人)，再由151人中就新產科組19位樣本之基本資料配對，配 對後的二組(各19人)再進行依變項之比較，以避免因二組樣本特質差異影響研究結果。研 充工具主要是研究者自擬之顧客滿意度問卷及作業流程成本分析調查表。研究結果顯示配對 後之二組產婦對所提供之產科健康照顧均頗滿意且滿意度類似，在剖腹產機率方面，二組均 未有剖腹產者，唯在生產的花費上，傳統組明顯高於新產科組。故本研究建議樣本醫院應繼 續提供此二種生產健康照顧模式，給予顧客多一種選擇之機會，同時應努力增加新產科健康 照顧組之樣本數，以提升本研究之公信度。

　　　　　The purposes of the study were (1) to establish a new obstetric service model characterized by Nurse-midwife attended births and a labor delivery recovery (LDR) program in the hospital; (2) to evaluate this new service model by comparing it with the existing obstetric service model of traditional obstetrician attended births, in terms of cesarean rate, clients' satisfaction with the service and care cost. A two-group comparison design is used. Nineteen pairs of women matched as closely as possible in terms of demographic differences were used for comparison. A client satisfaction questionnaire, a cost calculation sheet and a c/s record were utilized for data collection. Chi-Square, t-test and 95% confidence interval were employed for statistical analysis. Results reflected that clients of both services were equally satisfied with quality of care. There were no c-sections in either group. However, the cost of the traditional service was significantly higher than that of the new service model. Discussions of the limitations of the study and recommendations are included.