儿童医院和妇幼保健院发热门诊运营情况调查  

Investigation on the operation of fever clinics in children′s hospital and maternal and child health institutions

作　　者：中国初级卫生保健基金会儿科专家委员会 中国医药教育协会儿科专业委员会 中国研究型医院学会儿科学专业委员会 中国非公立医疗机构协会儿科专业委员会 中国中药协会儿童健康与药物研究专业委员会 中国医药新闻信息协会儿童安全用药分会 全球儿科呼吸联盟 蒋荣猛 麻晓鹏[4] 申昆玲[5,6] 梁芳芳 罗万军[7] 郑跃杰[4] 韩冰[2,3] 万钢[2,3] 沈红强 刘薇[9,10] 曾慧慧 邓继岿[4] 秦强[6] 张华甫[9,10] China Primary Health Care Education Foundation Committee on Pediatrics;China Medicine Education Association Committee on Pediatrics;Chinese Research Hospital Association Committee on Pediatrics;Chinese Non-Government Medical Institutions Association Committee on Pediatrics;China Association of Traditional Chinese Medicine,Committee on Children′s Health and Medicine Research;China News of Drug Information Association,Committee on Children′s Safety Medication;Global Pediatric Pulmonology Alliance;Jiang Rongmeng;Ma Xiaopeng;Shen Kunling

机构地区：[1]不详 [2]国家感染性疾病医疗质量控制中心 [3]首都医科大学附属北京地坛医院 [4]深圳市儿童医院 [5]国家儿童医学中心(北京) [6]首都医科大学附属北京儿童医院 [7]华中科技大学同济医学院附属武汉儿童医院 [8]浙江大学医学院附属儿童医院 [9]天津大学儿童医院 [10]天津市儿童医院 [11]首都医科大学附属北京妇产医院

出　　处：《中华实用儿科临床杂志》2023年第12期921-926,共6页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(72174138);北京市卫生健康委高层次公共卫生技术人才建设项目(2022-2-002)。

摘　　要：目的了解不同地区、不同级别儿童医院/妇幼保健院发热门诊设置和能力建设现况。方法分层随机抽取中国7个地区,30个省/自治区/直辖市296家儿童医院和妇幼保健院,调查其发热门诊患儿预检分诊、急救和病原检测能力、人员配置和院内感染防控等情况。组间比较采用χ2检验,Fisher′s确切概率法。结果调查分析结果显示,配置有独立的儿科发热门诊的医疗机构占84.12%(249/296),其中三级医疗机构109所(109/125,87.20%),二级医疗机构72所(72/171,42.11%);儿童医院中91.43%(32/35)设置了独立儿科发热门诊,而妇幼保健院独立设置率为46.71%(78/167),显著低于儿童医院(P<0.001);具有儿童医院和妇幼保健院双重职能的医疗机构,儿科独立发热门诊设置率为76.56%(49/64);西部地区(西南地区设置率为41.38%、西北地区设置率为47.06%)相对较低;51.41%的医疗机构发热门诊未配备有创或无创呼吸机等抢救生命支持类设备;新型冠状病毒、甲型和乙型流感病毒(包括核酸检测、抗原检测和抗体检测方法)在儿科发热门诊普及率超过90%,但腺病毒、呼吸道合胞病毒和肺炎支原体抗原检测方法普及率不足45%;三级医疗机构儿科发热门诊医师和护士的中位配置人数分别为5位和9位,并配有至少1位技师和药师;而二级医疗机构分别为3位和4位,三级医疗机构明显优于二级医疗机构(P<0.001),87.55%的发热门诊/诊室医务人员的人均绩效在医院所有临床科室排名位于平均水平以上。结论我国儿童医院/妇幼保健院中,儿科发热门诊的区域和人员配置较为规范,但部分医院已有发热门诊占地面积、接诊和急危重症救治能力不足;感染性疾病病原体快速检测项目普及尚需进一步提高,以期进一步满足儿科发热门诊常见和重点关注的病原早期筛查的迫切需求;如何依据各医疗机构就诊区域的软硬件、现有可利用医疗资源及诊疗现ObjectiveTo assess the current status of fever outpatient clinics and capacity building in children′s hospitals and maternal and child health institutions of different regions and levels.MethodsA total of 296 children′s hospitals and maternal and child health institutions from 7 regions and 30 provinces/autonomous regions/municipalities were randomly selected in this comprehensive study.The pre-triage,emergency and diagnostic capabilities,personnel allocation,and hospital infection prevention and control of fever outpatient clinics were investigated.Chi square test or Fisher′s exact probability method was used.ResultsThe results of investigation and analysis showed that 84.12%(249/296)of the medical institutions were equipped with independent fever clinics(consulting rooms),of which 109 were tertiary medical institutions(109/125,87.20%)and 72 were secondary medical institutions(72/171,42.11%).In children′s hospitals,91.43%(32/35)set up independent fever clinics,and the independent setting rate of maternal and child health care hospital was 46.71%(78/167),which was significantly lower than that of children′s hospitals(P<0.001);in the medical institutions with dual functions of children′s and maternal and child health care hospitals,76.56%(49/64)of the pediatric independent fever clinics were set up;the setting rate in western China(41.38%in Southwest China and 47.06%in Northwest China)was relatively low.The 51.41%of fever clinics in medical institutions were not equipped with life support equipment such as invasive or non-invasive ventilators;SARS-CoV-2,influenza A and B virus testing methods(including nucleic acid testing,antigen testing and antibody testing)were over 90%prevalent in pediatric fever clinics.However,the prevalence of adenovirus,respiratory syncytial virus and mycoplasma pneumoniae antigen detection was less than 45%.The average number of doctors and nurses in pediatric fever clinics in tertiary medical institutions was 5 and 9,respectively,and they all had at least 1 technician and pha

关 键 词：发热门诊 儿童医院 妇幼保健院 现状调查 

分 类 号：R197.5[医药卫生—卫生事业管理]