广州市流动儿童与户籍儿童卫生服务需求与利用状况的比较研究

Comparison of Health Service Demands and Utilization between Migrant Children and Local Children in Guangzhou

目的对比广州市流动儿童与户籍儿童卫生服务需求与利用状况,为改善流动儿童的身心健康状况提供依据。方法 2014年9月—2015年1月,结合便利、分层、随机、整群抽样等多种抽样方法,分别选取在广州市民办小学、公办小学就读的高年级(5~6年级)流动儿童、户籍儿童1 302例为调查对象。采用自行设计的《儿童卫生服务需求与利用状况调查表》对其进行调查,调查内容包括儿童一般资料及卫生服务需求与利用状况。结果流动儿童两周患病就诊率(54.8%)高于户籍儿童(41.9%)(P<0.05)。流动儿童过去1年内应住院未住院率(8.8%)高于户籍儿童(1.1%)(P<0.05)。流动儿童定期体检率(75.4%)低于户籍儿童(93.1%)(P<0.05);流动儿童建立健康档案率(17.3%)低于户籍儿童(24.2%)(P<0.05);流动儿童办理接种卡率(57.6%)低于户籍儿童(83.9%)(P<0.05);流动儿童完成"五苗"(乙型肝炎疫苗、卡介苗、脊髓灰质炎疫苗、白百破疫苗、麻疹疫苗)全程接种率(22.9%)低于户籍儿童(41.1%)(P<0.05)。结论与户籍儿童相比,广州市流动儿童卫生服务需求与利用率较低。

Objective To compare the health service demands and utilization between migrant children and local children in Guangzhou,providing an evidence for improving both physical and mental health of migrant children.Methods We conducted this survey from September 2014 to January 2015.Using convenience,stratified,random and cluster sampling,we selected a total of 1 302 senior grade students(including migrant children and local children in grades 5-6)from both private and public primary schools in Guangzhou.Using a self-developed Health Service Demands and Utilization in Children Questionnaire,we surveyed them for collecting the demographic data,and status about health service demands and utilization.Results Compared with local children,migrant children demonstrated higher rate of healthcare seeking due to illness in the past two weeks(54.8%vs 41.9%),higher non-hospitalization rate in the past one year although the inpatient treatment was needed(8.8%vs 1.1%),but lower rate of undergoing regular physical examination(75.4%vs 93.1%),lower rate of possessing health records(17.3%vs 24.2%),lower rate of owning a vaccination record card(57.6%vs 83.9%),and lower rate of completing the vaccination of 5 vaccines(hepatitis B vaccine,BCG,OPV,DPT vaccine,measles vaccine)(22.9%vs 41.1%)(P<0.05).Conclusion Migrant children showed less demands and lower utilization rate of health services compared with local children.