基于供需视角的基层卫生机构儿童保健服务现状分析

Analysis on the Current Situation of Children’s Health Care Service in Primary Health Institutions Based on the Perspective of Supply and Demand

目的:从供给和需求两个视角了解贵阳市基层卫生机构儿童保健服务现状,分析其存在的问题,为促进基层儿童保健服务提供参考依据。方法:2020年随机抽取贵阳市行政区内的40所基层卫生机构(20所乡镇卫生院、20所社区卫生服务中心)进行“基层卫生机构儿童保健服务情况”问卷调查,并在其辖区内随机选取1 733名儿童家长进行“儿童保健服务需求与满意度”问卷调查,同时对15名基层卫生服务机构负责人进行相关问题的定性访谈。结果:40所基层卫生机构心理行为评估咨询室均无检查设备,50%的社区卫生服务中心儿童保健门诊用房面积未达标。新生儿访视和3岁以下、7岁以下儿童健康管理指标总体达到国家和贵州省工作目标。乡镇卫生院新生儿访视管理率高于社区卫生服务中心,差异有统计学意义(χ^(2)=80.98,P<0.01)。儿童保健人员专科及以下学历者占69.44%(75/108),49.07%(53/108)未评职称。掌握基本儿童保健知识的工作人员占76.85%(83/108)。儿童家长对基层儿童保健服务总体满意度为84.02%。结论:相关部门应提升基层卫生机构儿童保健服务的硬件配套设施、人员配置和服务质量,以进一步适应新时期群众对儿童保健服务不断提高的需求。

OBJECTIVE To understand the current situation of primary child health services in Guiyang from the perspective of both the supply and demand sides, to analyze its existing problems, and to provide a reference for the promotion of grassroots child health services. METHODS Random selection of Guiyang administrative region of 40 grassroots health service institutions( 20 towns and townships, 20 community health service center) “grassroots health institutions children health care services” questionnaire,and within its jurisdiction randomly selected 1 733 children parents “child health service demand and satisfaction” questionnaire survey, at the same time to 15 grassroots health service institutions, head of the qualitative interview. RESULTS The psychological behavior assessment and consultation rooms of 40 grassroots health service institutions had no inspection equipment, and 50% of the child health clinics in community health service centers did not meet the standards. The health management indicators of neonatal visit, children under 3 years old and under 7 years old had generally reached the national and Guizhou provincial work targets. The management rate of neonatal visits in township health centers was higher than that in community health service centers, and the difference was significant( χ^(2)=80.98, P<0.01). Child health personnel accounted for 69.44%( 75/108) and 49.07%( 53/108) did not awarded professional titles. The basic child health knowledge was 76.85%( 83/108). Parent overall satisfaction with primary child health care services was 84.02%. CONCLUSIONS Basic-level child care needed to improve basic-level hardware, human resources, and service quality based on its fairness, so as to adapt to the ever-increasing needs of the grassroots for child health services in the new era.