Objective To investigate children′s medical-care-seeking behavior and explore the main influencing factors for children′s medical-care-seeking behavior , to guide children′s parents to conduct correct medical -care-seeking mode.Methods According to the administrative map of Guangzhou , we divided Guangzhou into three areas .Using pure random sampling method , we selected one district/county -level city from each area , and we at last selected Haizhu district , Baiyun district and Conghua district from the three different areas .In the three districts, we enrolled parents′of children as respondents by random encounter in the major gathering places for child ( in parks or at school gates ) .From April to June in 2014, a self-designed questionnaire for the status of children′s medical-care-seeking conduct in Guangzhou was adopted .The content of the questionnaire included children′s basic information , post processing mode after getting general diseases and its influencing factors, the medical setting chosen to seek medical care at the latest disease attack and its influencing factors .A total of 1 500 questionnaire were distributed , and 1 205 effective questionnaires were collected , with an effective recovery rate of 80.3%. Results For"general processing mode after finding diseases in children", there were 689 (57.2%) respondents who chose to observe first, 417 (34.6%) choose to seek for medical care immediately , 87 (7.2%) chose to purchase drugs from drugstore, and 12 (1.0%) chose to bring their children to visit doctors.The parents of children of different age ranges and with different time spent on the road from home to the nearest medical setting were significantly different in the choice of processing mode ( P<0.05 ) .In the latest disease attack in children , 424 ( 35.2%) firstly chose to seek for treatment in children hospital, 374 (31.0%) firstly chose primary hospital, 208 (17.3%) chose Grade A Class -three comprehensive hospital, 199 (16.5%) chose district-level maternal and child care service centre .The first choice of medical settings by parents varied with whether children had health insurance and the time spent on the road from home to the nearest medical setting (P<0.05) . The first five influencing factors for the medical setting chosen by children′s parents were short distance or convenient transportation from home ( 56.8%, 684 /1 205 ) , high medical care level ( 51.6%, 622/1 205 ) , good service attitude of medical workers (44.5%, 536/1 205), appropriate expense (33.0%, 398/1 205) and good medical facility (29.0%, 349/1 205) .Conclusion More than half of the parents whose children fall ill will observe first before seeking treatment , and the age of children and the time spent on the road from home to the nearest medical setting may be influencing factors for parents ′processing method of children falling ill; parents tend to choose children hospital for the first treatment , and the influencing factors for the first choice of medical setting may be whether children have medical insurance and the time spent on the road from home to medical setting; short distance or convenient transportation to home , and high medical level are significant factors for the choice of medical setting by parents to seek medical care for their children .%目的 了解广州市儿童的就医行为, 探讨影响儿童就医行为的因素, 以期引导儿童家长建立正确的就医模式. 方法 根据广州市行政区划图, 将广州市分为3个区域, 采用单纯随机抽样法, 在3个区域中各抽取1个区/县级市, 最终选取了海珠区、 白云区、 从化区, 在这3个区内的儿童主要聚集地 (公园或学校门口) 采用偶遇式方法抽取儿童家长作为调查对象. 于2014年4—6月, 采用自行设计的 《广州市儿童就医行为现状调查问卷》 进行调查,问卷主要内容包括儿童的基本情况、 患一般疾病后处理方式及其影响因素、 最近一次患病后选择就诊的医疗机构及其影响因素等. 发放问卷1 500份, 回收有效问卷1 205份, 有效回收率为80.3%. 结果 对于 "发现儿童患病后一般的处理方式", 有689 人 (占57.2%) 选择先观察病情再决定, 有417 人 (占34.6%) 选择立即就医, 有87 人 (占7.2%) 选择到药店买药治疗, 有12人 (占1.0%) 选择有时间再带儿童就医. 不同年龄、 从家到最近医疗点时间的儿童患病后, 家长选择的处理方式间差异有统计学意义 ( P<0.05 ). 在最近一次儿童患病后, 家长首选市级及以上儿童专科医院就诊的有424人 (占35.2%) , 首选基层医院的有374人 (占31.0%) , 首选三甲综合性医院的有208人(占17.3%) , 首选区级妇幼保健院的有199人 (占16.5%). 有无医保、 从家到最近医疗点时间不同的儿童患病后,家长首选的医疗机构间差异有统计学意义 ( P<0.05). 影响儿童家长选择首诊机构的前5位因素依次为: 离家近或交通便利 (56.8%, 684/1 205)、 医疗水平高 (51.6%, 622/1 205)、 医护人员服务态度好 (44.5%, 536/1 205)、 费用适宜 (33.0%, 398/1 205)、 医疗设备好 (29.0%, 349/1 205). 结论 儿童患病后半数以上的家长会先观察病情再就诊, 儿童年龄和从家到最近医疗点的时间可能是儿童患病后家长处理方式的影响因素; 儿童患病后家长首诊倾向于儿童专科医院, 有无医保和从家到最近医疗点的时间可能是家长选择首诊机构的影响因素; 离家近或交通方便、 医疗水平高是家长选择首诊机构的重要考虑因素.
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