基层医疗卫生机构儿科建设与服务提供研究  

Research on Pediatric Construction and Service Provision in Primary Health Institutions

作　　者：张小娟[1] 刘阳 彭博 曹晓琳 叶媛 朱坤 ZHANG Xiaojuan;LIU Yang;PENG Bo;CAO Xiaolin;YE Yuan;ZHU Kun(Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;Chinese Academy of Fiscal Sciences,Beijing 100142,China)

机构地区：[1]中国医学科学院医学信息研究所,北京市100020 [2]中国财政科学研究院,北京市100142

出　　处：《中国全科医学》2025年第10期1228-1235,共8页Chinese General Practice

基　　金：江苏基层卫生发展与全科医学教育研究中心(江苏省高校哲学社会科学重点研究基地)基金项目。

摘　　要：背景一直以来我国儿科资源主要集中在大医院,基层医疗卫生机构儿科较为薄弱。目前关于基层医疗卫生机构儿科建设和服务现状的研究主要集中在少数发达地区,缺乏全国面上最新进展情况的相关研究。目的分析我国基层医疗卫生机构儿科建设及服务提供情况。方法于2022年1—2月采用分层抽样方法调查6406家基层医疗卫生机构,自制调查表收集2021年度所有抽样基层医疗卫生机构儿科建设情况、儿科人力资源配置情况、儿科基本药物配置情况、儿科主要设备配置情况、儿科医疗和保健服务提供情况等相关数据,基于Stata 15.0开展描述性分析,并采用多元线性回归分析探讨基层医疗卫生机构儿科诊疗人次数和儿童健康管理率的影响因素。结果乡镇卫生院和社区卫生服务中心独立设置儿科的机构占比分别为31.41%(1488/4737)和39.07%(652/1669);乡镇卫生院平均每机构提供儿童基本医疗服务的全科医生和儿科执业医师分别为(1.33±2.52)人和(0.94±1.71)人,社区卫生服务中心分别为(1.95±3.80)人和(1.26±2.06)人。乡镇卫生院和社区卫生服务中心配备1~3种儿科基本药物的机构占比较高,分别为38.91%(1843/4737)和40.85%(694/1669)。除CT外,全自动生化仪、DR和B超的配备率均在80%以上。多元线性回归分析结果显示,机构类型、在岗职工总数、实际开放床位数、独立设置儿科、儿科执业医师数、提供儿科服务的全科医师数、儿童签约率和药品配备数量是儿科诊疗人次的影响因素(P<0.05);区域、在岗职工总数、儿童签约率是基层医疗卫生机构儿童健康管理率的影响因素(P<0.05)。结论基层医疗卫生机构儿科设置不足,人力、药品、设备等存在一定的程度的短缺,导致儿童医疗服务量不足且存在城乡差异,医防融合仍待落地。Background For a long time,pediatric resources in China have been mainly concentrated in large hospitals,and the pediatrics of primary health institutions are weak.Studies about the current situation of pediatric construction and service provision in primary health institutions are mainly concentrated in a few developed areas,and studies about the latest progress in the whole country are not found.Objective To analyze the construction and service provision of pediatrics in primary health institutions in China.Methods From January to February 2022,6406 primary health institutions were surveyed using stratified sampling and the self-made questionnaire was used to collect relevant data on pediatric construction,pediatric human resource allocation,pediatric essential drugs,major equipment allocation,pediatric service provision in all sampled primary health institutions in 2021.Descriptive analysis and multiple linear regression analysis were used to analyze the influencing factors of the number of pediatric consultations and the rate of child health management in primary health institutions by Stata 15.0.Results 31.41%(1488/4737)and 39.07%(652/1669)of township health centers and community health centers independently set up pediatrics,respectively.On average,the number of general practitioners providing services for children and pediatric practitioners in township health centers was(1.33±2.52)and(0.94±1.71),respectively,and the number of community health centers was(1.95±3.80)and(1.26±2.06),respectively.The proportion of institutions equipped with 1-3 kinds of pediatric essential drugs in township health centers and community health centers was relatively high,which were 38.91%(1843/4737)and 40.85%(694/1669),respectively.Except CT,the equipped rates of automatic biochemical instrument,DR and B-ultrasound are more than 80%.The results of multiple linear regression analysis showed that the types of institutions,the total number of employees,the actual number of beds,independent pediatricians,the number of pediatric

关 键 词：社区卫生服务中心 儿科 乡镇卫生院 卫生保健提供 

分 类 号：R197.1[医药卫生—卫生事业管理] R-05[医药卫生—公共卫生与预防医学]