社区医务人员儿科诊疗相关情况的调查与分析

Investigation and analysis of pediatric diagnosis and treatment of the community medical staff

目的:对上海交通大学医学院附属上海儿童医学中心医疗联合体区域内的社区医务人员儿科诊疗相关情况进行调研,为社区儿科诊疗的发展提供参考。方法:于2020年10月选取参与《医联体基层社区儿科常见病诊疗》培训的上海交通大学医学院附属上海儿童医学中心医疗联合体区域内的207名社区卫生服务中心医务人员作为研究对象进行问卷调查,共收到问卷207份,回收有效问卷207份,问卷有效回收率100.0%。结果:医务人员儿科诊疗相关专业知识总均分为(47.3±13.0)分,及格的医务人员仅44名(21.3%),在年龄、工作年限方面,社区医务人员儿科诊疗相关专业知识得分差异有统计学意义(P<0.05),年龄、工作年限与专业知识的掌握情况均成反比。社区医务人员对社区儿科门诊常见病的服务技能、基本服务设施、常用药品、诊断能力、治疗能力、处方能力及转诊识别能力的评价均较低(≤3.0分),仅17.9%的医务人员每周都接受儿科常见病咨询,19.9%的医务人员愿意加入社区儿科门诊,20.9%的医务人员愿意签约管理14岁以下儿童。结论:我国儿科医疗联合体存在诸如各级各类医疗机构参与度不够、服务开展不深入等问题,提升社区儿科诊疗能力需依托政府宏观推动、相关医疗机构带动及社区卫生服务中心对儿科门诊的投入共同完成。

Objective:To investigate the pediatric diagnosis and treatment of community medical staff in the medical consortium of Shanghai Children’s Medical Center Affiliated to School of Medicine,Shanghai Jiao Tong University,and to provide reference for the development of community pediatric diagnosis and treatment.Methods:In October 2020,207 community health service center medical staff who participated in the training of“common diseases diagnosis and treatment of pediatrics in primary-level community of medical consortium”in the medical consortium area of Shanghai Children’s Medical Center Affiliated to School of Medicine,Shanghai Jiao Tong University were selected as research subjects to conduct a questionnaire survey,and a total of 207 questionnaires were received,207 valid questionnaires were returned,and the effective response rate of questionnaires was 100.0%.Results:The total average score of professional knowledge related to pediatric diagnosis and treatment was(47.3±13.0),and only 44(21.3%)passed the examination,in terms of age and working years,there were significant differences in the scores of pediatric diagnosis and treatment related professional knowledge among community medical staff(P<0.05),and both age and years of service were inversely related to the scores.Community medical staff had low evaluations on the service skills,basic service facilities,commonly used drugs,diagnostic ability,treatment ability,prescription ability and referral recognition ability of community pediatric outpatient clinics for common diseases(≤3.0 points),only 17.9%of medical staff received pediatric common diseases counseling weekly,19.9%were willing to join community pediatric clinics,and 20.9%of medical staff were willing to contract to manage children under 14 years of age.Conclusion:In our country,pediatric medical consortium has problems such as insufficient participation of various medical institutions at all levels and in-depth service development,and improvement of the capacity of community pediatric diagnosis and treatment needs to rely on the government’s macro promotion,the promotion of relevant medical institutions and the investment of community health service centers in pediatric outpatient clinics.