文章摘要
关旭静,吴先萍,金必辉,唐雪峰.四川省2014-2018年贫困地区社区儿童健康管理现况调查[J].中华流行病学杂志,2020,41(1):79-84
四川省2014-2018年贫困地区社区儿童健康管理现况调查
Status of child health services in less developed areas in Sichuan province, 2014-2018
收稿日期:2019-04-28  出版日期:2020-01-14
DOI:10.3760/cma.j.issn.0254-6450.2020.01.015
中文关键词: 儿童保健;基层医疗卫生机构;贫困地区
英文关键词: Child health services;Primary medical institution;Less developed area
基金项目:
作者单位E-mail
关旭静 四川省疾病预防控制中心促进基本公共卫生服务均等化指导中心办公室, 成都 610041  
吴先萍 四川省疾病预防控制中心, 成都 610041  
金必辉 四川省疾病预防控制中心促进基本公共卫生服务均等化指导中心办公室, 成都 610041  
唐雪峰 四川省疾病预防控制中心, 成都 610041 sccdctxf@163.com 
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中文摘要:
      目的 了解四川省贫困地区基层医疗卫生机构儿童健康管理现状,为健康扶贫策略和措施的制定提供依据。方法 采取多阶段分层随机抽样方法,于2014-2018年在四川省21个市(州)分别抽取基层医疗卫生机构,现场抽查儿童健康档案,采用电话核实和实地调查等方法,调查基层医疗卫生机构儿童健康管理工作现状,及儿童监护人对儿童保健服务的满意度。采用描述分析、配对t检验、χ2检验、趋势性χ2检验、Pearson相关分析进行统计分析。结果 2014-2018年除儿童系统管理率外,贫困县反映儿童健康管理现状的指标均呈上升趋势(P<0.05);到2018年,各项指标已达到或接近全省平均水平。除儿童系统管理率外,贫困县反映儿童健康管理现状的指标均低于非贫困县,且大部分差异有统计学意义(P<0.05)。除儿童中医药健康管理服务率外,贫困县反映儿童健康管理现状的指标均高于深度贫困县,但大部分差异无统计学意义(P ≥ 0.05)。除儿童系统管理率外,贫困地区与非贫困地区各指标间的差距率均呈减小趋势,部分差异有统计学意义(P<0.05)。儿童监护人的满意度与儿童真实管理率(r=0.947,P=0.015)和儿童中医药健康管理服务率(r=0.996,P<0.001)相关。结论 贫困地区基层医疗卫生机构儿童健康管理服务取得一定成效,需制定更加有效的扶贫政策,进一步加大投入、提高服务水平,切实落实基本公共卫生儿童健康管理服务项目,助力脱贫攻坚工作。
英文摘要:
      Objective To understand the status of child health services by primary medical institutions in less developed areas in Sichuan province and provide evidence for the development of health policy for poverty alleviation. Methods Annual child health records in the primary medical institutions selected through multistage stratified sampling in 21 prefectures in Sichuan were extracted during 2014-2018. Field survey and telephone interview were used to evaluate the performance of child health services provided and the child guardian's satisfaction degree. Sample descriptive statistics, pair sample t-test, χ2 test, trend χ2 test, Pearson correlation analysis were used for statistical analysis. Results Except child system management rate, the other indicators reflecting the status of child health service in less developed areas in Sichuan were on rise (P<0.05), and close to average level of whole province in 2018. Except child system management rate, the other indicators reflecting the status of child health management in less developed counties were lower than those in developed counties in Sichuan, most differences were significant (P<0.05). Except child health management rate of traditional Chinese medicine, the other indicators reflecting the status of child health management in less developed counties were higher than those in poverty-stricken counties in Sichuan, most differences were not significant (P ≥ 0.05). Except child systematic management rate, the gap in indicators reflecting child health service status between less developed area and developed area was in reduction, some difference were significant (P<0.05). The child guardian satisfaction degree was associated with true child health management rates (r=0.947, P=0.015), and child health management rate of traditional Chinese medicine (r=0.996, P<0.001). Conclusions Some achievements have been made in child health services provided by primary medical institutions in less developed areas in Sichuan. To achieve the 2020 poverty alleviation goal, it is necessary to take measures to increase input and improve service level.
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