摘要
目的了解桂林市基层医疗机构的儿童保健服务能力现况。方法选择2019年桂林市具有儿童保健服务资质的所有城乡基层医疗机构共148所,其中乡镇卫生院136所,社区卫生服务中心12所。采用自制问卷调查两类基层医疗机构的拨款方式、儿童保健相关专科服务项目的开展情况、儿童保健相关管理服务工作情况及儿童保健服务覆盖率。总结存在的不足并提出改建对策和建议。结果(1)2019年桂林市的基层医疗机构的运转仍以国家拨款为主,与儿童保健业务相关的用房面积、收入、支出占比均不足5%。从事儿童保健的人员不足,且以低学历、低职称人员为主。两类基层医疗机构的机构拨款方式差异有统计学意义,且社区卫生中心的2019年度儿童保健总收入及其占总收入的比例、医疗机构总支出、儿童保健总支出及其占总支出的比例、从事儿童保健在岗人数及其占总医疗机构总在岗人数的比例,以及从事儿童保健工作人员的学历及职称构成,均高于或优于乡镇卫生院(均P<0.05)。(2)部分儿童保健相关专科服务项目开展情况不乐观,其中儿童康复门诊的开展情况最差,总体开展率低于1%,儿童心理门诊、儿童营养门诊、耳保健门诊的总体开展率均在10%以下。社区卫生中心开展儿童心理门诊及耳保健门诊的比例均高于乡镇卫生院(均P<0.05)。(3)新生儿访视率、7岁以下儿童健康管理率、3岁儿童系统管理率均超过90%。80%以上的基层医疗机构提供了贫血专案管理、佝偻病专案管理、高危儿专案管理、辖区5岁以下儿童死亡监测服务、托幼机构卫生指导、预防接种计划免疫服务等保健服务项目。乡镇卫生院开展辖区内严重缺陷儿追访、辖区内自动出院危重儿童追访和辖区内地中海贫血儿童追访情况均优于社区卫生中心(均P<0.05)。结论桂林市儿童保健投入不足,业务拓展困难;从�
Objective To understand the status quo of primary medical institutions′capability for providing children health care services in Guilin City.Methods A total of 148 urban and rural primary medical institutions in Guilin City qualifying for children health care services were selected,including 136 rural hospitals and 12 community-level health service centers.A self-made questionnaire was used to investigate these two kinds of primary medical institutions with respect to appropriation ways,the implementation of specialty service projects related to children health care,the status of children health care-associated management services,and the coverage rate of children health care services.The existing problems were summarized and the countermeasures and suggestions for renovation were put forward.Results(1)In 2019,the operation of the primary medical institutions in Guilin City were still mainly funded by the state,and the ward area,income,and expenditure associated with children health care businesses accounted for less than 5%.The employees engaged in children health care were insufficient,and most of them had lower educational levels or lower professional titles.There were statistically significant differences in the institutional appropriation way between these two kinds of primary medical institutions;moreover,community-level health service centers,in 2019,were higher or better than rural hospitals in terms of the total income involved in children health care and its share in the institutions′total income,medical institutions′total expenditure,total expenditure involved in children health care and its share in the institutions′total expenditure,number of on-the-job employees engaged in children health care and its share in the total number of medical institutions′on-the-job employees,as well as the constitution of education levels or professional titles of employees engaged in children health care(all P<0.05).(2)The implementation of some children health care-related specialty service projects was not
作者
曾建娟
谢薇
卢艳云
ZENG Jian-juan;XIE Wei;LU Yan-yun(Department of Health Care,Guilin Maternal and Child Health Hospital,Guilin 541001,China;Department of Child Health Care,Guilin Maternal and Child Health Hospital,Guilin 541001,China)
出处
《广西医学》
CAS
2022年第3期303-307,共5页
Guangxi Medical Journal
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190565)。
关键词
儿童保健
基层医疗机构
服务能力
城乡差异
桂林市
Children health care
Primary medical institution
Service capability
Gap between urban and rural areas
Guilin City
