高危儿分类转诊对社区儿童保健工作的影响

Effect of classified referral of high risk infants on child health care in community

目的分析高危儿分类转诊模式对社区儿保工作的影响。方法 2014年4月在交通社区实行高危儿分类转诊,观察分类转诊后社区高危儿的分布情况,并对分类转诊前后社区高危儿转诊情况及高危儿家长转诊态度调查情况进行分析。结果分类转诊前共建档395人,高危儿110例,分类转诊后共建档478人,高危儿143例,Ⅰ类高危儿108例,Ⅱ类高危儿35例。分类转诊后转诊率明显低于分类前(P<0.01);分类后转诊依从率明显高于分类前(P<0.01);分类转诊前后高危儿筛查率、阳性率、专案管理率差异无统计学意义(P>0.05)。Ⅱ类高危儿家长对高危儿转诊必要性、依从性、了解程度明显高于I类高危儿家长(P<0.01)。结论高危儿分类转诊是高危儿系统管理的重要环节,能提高高危儿随访依从性,促进高危儿社区管理模式完善,可在社区儿童保健中推广。

Objective To explore the effects of classified referral of high risk infants on child health care in community. Methods From April 2014 classified referral of high risk infants were carried out in Jiaotong community,distribution of high risk infants were observed after referral.Referral situation before and after classified referral and attitudes of parents of high-risk infants were analyzed. Results There were 395 infants before classified referral,110 high risk infants,and there were 478 infants after classified referral,143 high risk infants,including 108typeⅠ and 35typeⅡ.The referral rate after classified referral was significantly lower than that before classified referral（P〈0.01）;the compliance rate was significantly higher than that before classified referral（P〈0.01）;There were no significant differences of the screening rate,positive rate and rate of project management between the two groups（P〉0.05）.The necessity,compliance and understanding of parents of high risk infants of typeⅡ were much higher than those of parents of typeⅠ（P〈0.01）. Conclusion As the important part of systematic management of high risk infants,classified referral of high risk infants could improve the compliance,promote the community management mode of high risk infants,and could be popularized in child health care of community.