目的 分析成都农村学校留守儿童两周患病未就诊原因及影响因素,为制定有效的干预措施提供依据。方法 随机抽取2015年1-12月成都市6个镇的468名农村学校留守儿童及其监护人。通过问卷调查的方式收集留守儿童与监护人的一般情况及两周患病率、两周患病未就诊率。结果 此次调查留守儿童自报两周内患过病150人,两周患病率为32.05%,其中未就诊19人,两周患病未就诊率为12.67%。不同性别、是否独生子女、监护人不同性别、年龄和文化程度、医疗费用不同支付方式、不同家庭月收入的成都农村学校留守儿童两周患病未就诊率比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,留守女童(OR=1.408,95%CI:1.260~1.73),监护人年龄60岁及以上(OR=1.533,95%CI:1.396~1.837)为成都农村学校留守儿童两周患病未就诊的独立危险因素,独生子女(OR=0.502,95%CI:0.220~0.813),女性监护人(OR=0.644,95%CI:0.302~0.785),监护人小学以上文化程度(OR=0.675,95%CI:0.309~0.858),家庭月收入≥3 000元(OR=0.607,95%CI:0.330~0.891)为成都农村学校留守儿童两周患病未就诊的独立保护因素(P<0.05)。结论 成都农村学校留守儿童患病两周未就诊率整体处于较低水平,主要受留守儿童性别、是否独生子女、监护人性别、监护人年龄、监护人文化程度、家庭月收入的影响。应加强对留守儿童及其监护人的健康教育。

Objective To analyze the causes and influencing factors related of two-week absence of medical treatment for left-behind children in rural areas of Chengdu,in order to provide scientific evidence for making health services policies. Methods Totally 468 left-behind children and their guardians were randomly selected from six towns of Chengdu city from January to December in 2015. The general situation of left-behind children,the general condition of the caregiver and the two-week prevalence rate,and the two-week non-diagnosis rate were investigated by questionnaire survey. Results In this survey,150 left-behind children reported had been sick within two weeks,the two-week prevalence rate was 32.05%. Among them,19 patients were not treated,and the rate of undiagnosed patients in the two weeks was 12.67%.There were significant differences in the untreated rate of two-week illness of left-behind children in Chengdu with different gender,whether they had only one child,the different gender,age and education level of the guardian,the payment method of medical expenses,and the monthly family income(P<0.05). Logistic regression analysis showed that left-behind girls (OR=1.408,95%CI:1.260~1.733),guardians aged 60 years and over (OR=1.533,95%CI:1.396~1.837) were independent risk factors for untreated of two-week illness of left-behind children in rural areas in Chengdu. Only child (OR=0.502,95% CI:0.220~0.813),female guardian (OR=0.644,95%CI:0.302~0.785),guardian′s education level above primary school (OR=0.675, 95% CI:0.309~0.858),the family monthly income of 3 000 yuan or more (OR=0.607,95%CI:0.330~0.891) were the independent protective factors(P＜0.05). Conclusionss In Chengdu rural schools,the untreated rate of two-week illness of left-behind children is generally at a low level,which is mainly affected by the gender of left-behind children,whether they are only children,the gender of guardians,the age of guardians,the cultural level of guardians and the monthly income of families. Health educations should be promoted among left-behind children and guardians.