我国医疗卫生机构儿科服务现状研究

目的通过调查了解全国不同地区不同级别医疗卫生机构儿科服务提供现状、变化趋势以及儿科服务能力，发现我国儿科服务中存在的问题。方法在全国随机抽取44个城市，对提供儿科住院服务的医疗卫生机构进行问卷调查。结果县区级医疗卫生机构儿科出院人次占辖区儿科总出院人次的比例最高（51．2％）；2008—2010年不同级别的机构儿科出院人次均呈逐年上升趋势，以县区级机构增长幅度最大，2010年增长幅度达到16．1％。能提供综合性新生儿科服务的机构中，以市级及以上机构比例最高（70．O％），其次是县区级机构（64．9％），乡级机构最低（16．0％）。23．6％的乡级机构尚不能提供基本新生儿科服务。新生儿死亡病例以发生在县区级机构比例最高（46．3％），其次是乡级机构（32．6％）。新生儿死亡原因以早产和低出生体重、出生窒息死亡比例最高。结论县区级医疗卫生机构在我国儿科医疗服务中发挥了重要作用；提高儿科服务能力．需重点关注基层医疗卫生机构；加强儿科适宜技术在基层医疗卫生机构的推广，提高其服务能力。

The present research on the pediatric service in medical health institution in China

[ Objective ] Through investigating the pediatric service providing and ability of medical institution in different areas and different levels to find problems existing in the pediatric service in our country. [ Methods ] 44 city-regions were randomly selected in the whole country and survey all the medical institutions providing hospitalization service for children in sampling areas with questionnaire. [ Results ] The number of pediatric inpatients in county level institutions accounted for 51.2% of total number of all medical institutions. The number of pediatric inpatients had risen from 2008 to 2010 in different levels institutions, the number of pediatric inpatients in county level institution grew fastest, increasedl6.1% in 2010. Among medical institutions providing neonatal comprehensive service, the municipal level and higher had the more proportion than the county level and township level which are respectively 70.0%, 64.9%, 16.0%. The proportion of township institution can＇ t provide essential neonatal service is 23.6%. The death cases in neonatal department in county level institutions had the most proportion which is 46.3%, and next is the township institution （32.6%）. The main causes of perinatal death are premature delivery, low birth weight and birth asphyxia. [ Conclusion ] The medical institution in county level play an important role in pediatrics health care. We should focus on primary-level medical institution to improve its service ability of pediatrics. Appropriate technology of pediatrics should be spread to improve service ability of pediatrics in primary-level medical and health care institution.