皖北农村留守儿童就医现状分析及对策探讨

目的:了解皖北农村留守儿童卫生服务利用状况及影响因素,为促进留守儿童健康成长和卫生服务公平发展提供建议。方法:对皖北地区2所农村小学437名学生实施问卷调查,并对248名监护人和部分基层医护人员进行访谈。结果:留守儿童四周患病率60.6%稍高于非留守儿童的59.3%,但差异无统计学意义(P>0.05);留守儿童患病后未采取任何措施占9.5%,高于非留守儿童的6.5%(P<0.05)。生病未就诊原因中:14.6%的单亲留守儿童选择经济原因,高于双亲和非留守儿童(P<0.01);双亲和单亲留守儿童选择"无人陪同"比例高于非留守儿童(P<0.01)。Logistic 回归分析:独生子女、父母外出务工时间、参加医保情况、父母文化程度、家庭人口数等因素对留守儿童的卫生利用情况产生影响。结论:农村留守儿童和非留守儿童卫生需求差别不大,他们的实际就医行为比例相对较低,故应加大农村留守儿童卫生服务保障力度。

Analysis of medical service for the rural left-behind children in the northern part of Anhui and its countermeasures

Objective:To analyze the medical service for the rural left-behind children in the northern part of Anhui, and provide the countermeasures in the healthy growth and fair health service development of children.Methods:Four hundred and thirty-seven pupils of primary school from the northern part of Anhui province were investigated by questionnaire, 248 guardian and part of the grassroots medical workers were interviewed.Results:The prevalence rates in 4 weeks old left-behind children and non-left-behind children were 60.6% and 59.3%, respectively, the difference of which was not statistically significant(P>0.05).The untreatment rate in left-behind children after illness(9.5%) was higher than that in non-left-behind children(6.5%)(P<0.05).Among the reasons of untreatment, the economy reason in single parent left-behind children(14.6%) was higher than that in double parents non-left-behind children(P<0.01).The selecting the "unaccompanied" proportion in single and double parents left-behind children was higher than that in non-left-behind children(P<0.01).Logistic analysis showed that the only child, time of parents work outside, hospitalization insurance, education level of parents and family population affected the medical service use of the left-behind children.Conclusions:The difference of the medical service use between rural left-behind and non-left-behind children is little, the proportion of their medical behaviors after illness is relatively low, the health service for rural left-behind children should be strengthened.