于果，　齐建光,，　姚弥，　庞璐璐，　闫辉



从一次义诊看北京市社区儿童就医需求及其影响因素

于果1，齐建光1,2，姚弥2，庞璐璐1，闫辉1

【摘要】目的通过北京市某三甲医院儿科的一次义诊，了解北京市社区儿童健康需求、就医现状及其影响因素。 方法采取横断面调查的方法，对参加“社区儿童义诊”的111名儿童及其家长进行问卷调查。 结果①家长在社区最需要解决的儿童问题排在前5位的是喂养、饮食问题，皮疹，生长发育，呼吸和消化系统相关问题。②孩子生病就诊首选医疗机构，以儿童专科医院(44.1%)和三级医院(39.6%)为主。选择大医院就诊的主要原因是医生水平高、医院有名气和就近方便。③一半家长认为平时带孩子看病很困难/困难，最主要原因是挂不上号和等候时间长。④若社区医院有能看儿童疾病医生的情况下，76.6%家长会选择带儿童在社区卫生服务中心就诊。结论儿童医疗卫生服务水平和就近方便是影响家长就医机构选择的重要因素。加强社区卫生服务中心对于儿童常见健康问题及常见疾病的诊疗能力，通过宣传引导家长合理就医，是实现儿童就医分层诊疗的必备条件。

【关键词】社区；儿童健康；就医；义诊

Children’s Medical Needs in Community and Related Influencing Factors in Beijing: A Perspective from Free Consultations

YU Guo， QI Jianguang，YAO Mi, et al.DepartmentofPediatrics,PekingUniversityFirstHospital,Beijing100034，China

【Abstract】ObjectivesTo investigate the children’s medical needs and current situation in community and related influencing factors from free consultations organized by one Grade-Three A-level hospital in Beijing. MethodsA questionnaire survey was conducted among 111 children and their families who participated in the community free consultations. Results①Top five problems of the children’s medical needs in community from their families were feeding and eating problems, skin rashes, growth and development, and conditions related to respiratory and digestive system. ② The first choice of medical service institutions were Children Hospital (44.1%) and Grade-Three Hospital (39.6%) when children get sick, for the reason that doctors' good ability, hospitals' reputation and distance accessibility. ③Half children's families thought accessing medical service was hard or difficult, for the reason that hard registration and long waiting time. ④76.6% children's families would firstly choose the community health institutions when children get sick if there were doctors who could manage the conditions.Conclusions The important influencing factors of medical service institution choice for children's family are the ability of managing children medical health issues and distance accessibility. Strengthening primary care ability on managing common health problems and diseases and conducting propaganda about accessing medical service reasonable in children's families are the essential conditions in accomplishing the medical delivered system.

【Key words】 Community;Children health;Medical needs;free consultation

目前，大力发展基层医疗是世界性的大趋势[1]，也是我国现阶段医疗体制改革的方向。当今社会人们对儿童身心健康的关注越来越高。社区卫生服务中心作为儿童的初级医疗卫生保健机构，应承担起预防保健、儿童疾病首诊及合理转诊、常见疾病诊疗、健康教育等职责[2]。……