【作者】 吴雯；

【导师】 张翔；

【作者基本信息】 华中科技大学 ， 社会医学与卫生事业管理， 2011， 硕士

【摘要】 目的:通过对黔江区农村留守儿童基本情况和门诊、住院情况的调查,了解黔江区留守儿童的基本情况以及其卫生服务利用情况,了解非留守儿童和留守儿童卫生服务需要和利用方面的不同,分析影响留守儿童的卫生服务利用的因素,提出改善农村留守儿童卫生服务利用状况的对策和建议,希望能够以此改进留守儿童的健康状况,促进社会的稳定。资料与方法:利用文献分析法了解目前中国农村留守儿童的现状和分布情况,以及其卫生服务利用的影响因素,制定相应的调查问卷对研究对象进行调查。在黔江区选择60个村,每个村选择20户家庭,对每户的家庭成员进行调查,收集其中的留守儿童信息进行分析。采用的方法主要有:1.文献分析法。2.问卷调查法.3.统计学方法。结果:(1)黔江地区0-15岁留守儿童占儿童总数的31.23%,其中少数民族的留守儿童占79.9%,男性占56.5%。(2)留守儿童两周患病率7.7%,略高于非留守儿童。母亲和祖父母为照顾者的留守儿童比较多,占80.2%,而照顾者为其他人的组留守儿童患病率最高。留守儿童有90.42%参加了医疗保险,其中参合率为86.9%。健康体检率为48.2%,两周就诊率为4.47%,住院率2.47%,均略高于非留守儿童。公共卫生服务方面,0-36月龄的留守儿童疫苗接种不规范,健康档案建档率为45.4%,除测身高、测体重、体格检查外,其他健康管理项目使用率均不高。(3)以两周就诊情况、体检情况、住院情况作为指标衡量年龄、性别、民族、照顾者、收入、和医疗单位距离、医疗保险情况对留守儿童卫生服务利用的影响,得出结论是性别、年龄、民族、照顾者以及和医疗单位的距离是影响因素,其他两方面则影响不大。结论与建议:针对目前西部农村地区留守儿童卫生服务利用不足的问题,可以从以下方面解决。(1)加大对农村基层卫生服务机构的建设力度,完善基础设施建设。(2)完善留守儿童相关法律制度,加强公安、卫生、民政部门的合作。(3)加快农村地区的经济发展水平,鼓励农民工回乡工作。(4)注重学校和照顾者对留守儿童的双重关心,加强与儿童父母的沟通。(5)鼓励民族医学的发展,设立专门准入机制。(6)促进公共卫生服务均等化建设,发展村医上门服务。更多还原

【Abstract】 Object: By the survey of the basic situation and study of the out-patient and in-patient cases of children left behind in Qianjiang district, to learn the basic situation of the children left behind and their health service utilization and the differences of their health service needs and utilization between the non-left-behind children. Through the study above I analyzed the influence factors of health service utilization of children left behind and then supposed some suggestions and measures to improve the utilization of health services of children left behind, in the hope of improving health service utilization of children left behind and promote social stability.Data and method: Using document analysis to understand the current status and distribution of rural children left behind in China and the influencing factors of their health service utilization then develop appropriate survey for the study. Choose 60 villages in Qianjiang district, and select 20 families in each village. Collect and analyze the imformation of children left behind in the family survey. Methods used are: 1. Document analysis. 2. Questionnaire .3. Statistical methods.Results: (1) children left behind accounts for 31.23% in children aged 0-15 of the total in Qianjiang region, including children left-behind of ethnic minorities accounted for 79.9%, 56.5% male.(2) Two-week prevalence rate of children left behind was 7.7%, slightly higher than the non-left-behind children. There were more children left behind whose mother or grandparents as caregivers, accounting for 80.2%, while those children left behind in the group that their caregiver was other people has the highest prevalence rate. 90.42 % of total children left behind have medical insurance; including 86.9% participate in the new rural cooperative medical care insurance. Children had physical examination took a rate of 48.2%, while their two weeks visiting rate was 4.47%, hospitalization rate was 2.47%,and all were slightly higher than the non-left-behind children. In terms of public health services, 0-36-month-old vaccination of children left behind was not normal and only 45.4% of the children left behind had archiving files. The utilization of other health management programs was not high except height measurement and weight measurement, physical examination.(3) Use two-week treatment conditions, the physical examination, hospitalization situation as indicators to measure the influence of age, gender, ethnicity, caregivers, income, distance to medical units, medical insurance situation on the utilization of health service of children left behind , concluded that gender, age, nationality, caregivers and the distance to medical units are the factors, the other two had little impact.Conclusion: To solve the current problem of inadequate utilization of health services of children left-behind in the western rural areas, the author promoted some suggestions as follows:(1) Countries should strengthen primary health services in rural construction, strengthen rural infrastructure,(2) Improve the legal system relating to children left behind, and strengthen the cooperation of public security, health, civil affairs departments.(3) Speed up economic development in rural areas, and encourage the migrant workers to work in their hometown.(4) Focusing on double care schools and caregivers give to children left behind, and strengthens the communication with the children’s parents.(5) Encourage the development of national medicine, and set up special access mechanism.(6) Promote construction of equalization of public health services, and develop door-to-door service of village doctors.更多还原