目的 了解广州市残疾儿童的卫生服务利用现状并探讨其影响因素,为有关部门改善残疾儿童卫生服务利用提供依据。方法 采用研究者自行设计的“残疾儿童卫生服务利用调查表”对广州市残疾人康复中心及4所特殊学校的残疾儿童家长进行问卷调查。结果 共回收有效问卷511份。1)残疾儿童的两周就诊率为25.2%,影响因素为儿童年龄、就读方式、家长健康状况及家庭接受最低生活保障救助情况(P<0.05);2)残疾儿童的年住院率为17.2%,影响因素为儿童年龄、残疾等级、家长了解早期干预情况(P＜0.05);3)疫苗全程接种率为61.1%,定期体检率为21.5%,影响因素为儿童就读方式及家庭接受最低生活保障救助情况(P<0.05);4)残疾儿童康复利用率为58.9%,影响因素为儿童年龄、残疾类型、独生子女、就读方式及家长了解早期干预情况等(P＜0.05),随访复查率为19.2%。结论 残疾儿童卫生服务利用相对不足,卫生服务可及性与利用服务的主动性有待改善;相关部门应建立合理、有效的卫生服务保障体系,优化卫生资源可及性;同时加强残疾儿童的预防保健及早期干预,提高家长利用服务的主动性,以促进残疾儿童健康成长。

Objective To investigate the current situation and influencing factors of health service utilization among disabled children in Guangzhou,in order to provide evidence for improving the utilization of health services for disabled children. Method A questionnaire survey was conducted on parents of disabled children in Guangzhou Rehabilitation Center and 4 special schools by using the self-designed questionnaire for Health Services of Disabled Children. Results Totally 511 valid questionnaires were returned. 1) The two-week consultation rate of disabled children was 25.2%,and the influencing factors included children′s age,study style and the health status of children′s parents and accept minimum living allowance(P<0.05). 2) The annual hospitalization rate of disabled children was 17.2%,and the influencing factors included children′s age and disability grade,parents′ understanding of early intervention (P<0.05). 3) Vaccination rate of disabled children was 61.1%,and regular physical examination rate was 21.5%. The factors influencing regular physical examination rate were study style and accept minimum living allowance (P<0.05). 4) The rehabilitation training rate for disabled children was 58.9%,and the influencing factors included children′s age,types of disability,being an only child,study style and parents′ understanding of early intervention (P<0.05). And the rate of regular follow-up was 19.2%. Conclusions The accessibility and initiative awareness of health services are insufficient,and the utilization of health services among disabled children is suggested to be improved. A reasonable and effective social security system of health services should be established to optimize the accessibility of health resources,strengthen the health education of prevention and early intervention of disabled children,improve the initiative of parents to use services,thereby promoting the healthy growth of disabled children.