上海市远郊农村儿童卫生服务需求与全科医生医疗能力匹配度调查

Survey on matching of children’s health service needs and general practitioners’medical capability in outer suburbs of Shanghai

目的调查上海市远郊农村居民在儿童健康管理和儿科疾病诊疗方面的需求与社区全科医生的儿科医疗能力的匹配情况。方法采用便利抽样法于2018年3-4月在上海市浦东新区5个农村区域开展调查。选择辖区内长期居住的儿童家长500名,辖区内5家社区卫生服务中心的全科医生100名,进行需求与能力的问卷调查。结果问卷有效率97.5%(585/600)。问卷调查的32个卫生服务项目中,家长的需求度与家长对全科医生的能力水平的评价均存在统计学差异(P<0.05)。居民需求度较高的卫生服务包括小儿咳嗽的诊治(4.34±0.73)分、扁桃体炎的诊治(4.33±0.74)分、小儿发热的诊治(4.33±0.74)分、儿童常见病诊断与治疗(4.30±0.70)分及预防接种指导与咨询(4.29±0.75)分。在不同维度中,对于不同年龄段儿童进行健康指导是社区家长所需要,而全科医生能力明显不能匹配的,di值均大于2.0。结论远郊农村居民对社区卫生服务中心提供儿童健康管理和儿科诊疗方面的卫生服务需求强烈,但是全科医生儿科医疗能力不能完全匹配需求,需要在普及常见病诊疗知识的基础上,强化儿童保健相关内容的培训,切实满足居民的卫生需求。

Objective To investigate the extent of the matching between the health service needs of children and the medical capability of community general practitioners in the outer suburbs of Shanghai.Methods A survey was conducted in rural areas of Shanghai from March to April of 2018.Subjects were selected from 500 parents and 100 general practitioners.Results The effective response rate of the questionnaire was 97.5%(585/600).In all of the surveyed health service items,there were significant differences between parents’needs and the evaluation of current service provision(P<0.05).The most needed health services included the diagnosis and treatment of cough(4.34±0.73),tonsillitis(4.33±0.74),pyrexia(4.32±0.74),common diseases in children(4.30±0.70),and vaccination counseling(4.29±0.75).In different dimensions,health guidance for children of different ages was what parents in community needed.General practitioners’di who could not accord with that were all above 2.0.Conclusion The suburb residents have a strong demand for health services in children.However,general practitioners’medical ability in children can not completely meet the needs.It is suggested that children related training be strengthened to meet the needs of residents based on diagnosis and treatment knowledge of common diseases.