Care-seeking and quality of care for outpatient sick children in rural Hebei, China: a cross-sectional study.
Care-seeking and quality of care for outpatient sick children in rural Hebei, China: a cross-sectional study.
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DOI：
10.3325/cmj.2013.54.541
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发表时间：
2013-12
影响因子：
1.9
通讯作者：
Scherpbier RW
中科院分区：
文献类型：
--
作者：
Zhang Y;Wu Q;van Velthoven MH;Chen L;Car J;Li Y;Wang W;Scherpbier RW
[目的]评价中国地区赵县乡村医生儿科门诊服务质量、儿童常见病患病率、就医行为及重点干预覆盖率。我们进行了两次横断面调查：1)孕产妇、新生儿和儿童健康家庭调查，包括1601名两岁以下儿童的照顾者；2)卫生设施调查，由当地卫生工作者对348名5岁以下患病儿童进行病例管理，并评估卫生设施中药品和用品的可获得性。我们的家庭调查显示，发热、咳嗽和腹泻的患病率分别为16.8%、9.2%和15.6%。患有发烧、咳嗽和腹泻的儿童的照顾者主要到村卫生室和乡镇卫生院寻求治疗。只有41.2%的疑似肺炎儿童接受了抗生素治疗，极少数腹泻儿童接受了口服补液剂(1.2%)和锌(4.4%)。我们的设施调查表明，很少有患病儿童得到全面评估，与黄金标准相比，卫生工作者只有43.8%的儿童得到了正确的分类。患病儿童的抗生素使用率很高，不符合指南。我们发现，赵县门诊患病儿童的服务质量很差。既然儿童疾病综合管理战略在中国的一些地区对儿童健康产生了积极的影响，那么建议在其他地区也实施。
To assess the quality of outpatient pediatric care provided by township and village doctors, prevalence of common childhood diseases, care-seeking behavior, and coverage of key interventions in Zhao County in China. We conducted two cross-sectional surveys: 1) maternal, newborn, and child health household survey including1601 caregivers of children younger than two years; 2) health facility survey on case management of 348 sick children younger than five years by local health workers and assessment of the availability of drugs and supplies in health facility. Our household survey showed that the prevalence of fever, cough, and diarrhea was 16.8%, 9.2%, and 15.6% respectively. Caregivers of children with fever, cough, and diarrhea sought care primarily in village clinics and township hospitals. Only 41.2% of children with suspected pneumonia received antibiotics, and very few children with diarrhea received oral rehydration solutions (1.2%) and zinc (4.4%). Our facility survey indicated that very few sick children were fully assessed, and only 43.8% were correctly classified by health workers when compared with the gold standard. Use of antibiotics for sick children was high and not according to guidelines. We showed poor quality of services for outpatient sick children in Zhao County. Since Integrated Management of Childhood Illness strategy has shown positive effects on child health in some areas of China, it is advisable to implement it in other areas as well.
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3.3
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通讯作者：
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通讯作者：
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作者：
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通讯作者：
Scherpbier RW