目的 充分整合利用基层和顶级临床儿科资源,建立北京市儿童心理保健双向转诊平台,为心理发育偏离和可疑行为问题儿童提供便利的全方位诊断和综合干预管理服务,达到理想康复效果。方法 利用北京市儿童心理保健双向转诊平台,以2018年11月9日至2019年12月31日期间全市16区儿童早期发展中心(儿早中心)上转的558例心理行为发育偏离儿童为研究对象,通过对其相关诊断、综合干预、定期监测及随访管理过程的资料分析,开展转诊平台建设的实践研究,完成平台运行效果的初步评估。结果 558例上转儿童中,接诊机构保健中心通过院内转诊方式协作完成诊断性发育评估、医学行为观察及必要的病因检查基础上,确诊心理行为问题524例(93.91%),构成占比前4位由高到低依次是:全面发育迟缓301例(53.94%)、语言发育迟缓119例(21.33%)、孤独症谱系障碍61例(10.93%)及运动发育迟缓29例(5.20%)。定期随访显示,其中408例(77.86%)正在保健中心和区儿早中心综合管理下接受多种形式的康复干预,有效率达29.77%。结论 本转诊平台充分整合多级别及多学科的医疗资源,开展高效的双向转诊,实施综合干预管理,便民利民,是全面优化儿童心理保健服务模式的成功实践。

Objective To make full use of the resources of grassroots and top professional pediatric hospitals,establish a two-way referral platform for children's mental health care in Beijing,in order to provide convenient diagnosis and comprehensive intervention management services for children with psychological development deviation and suspicious behavior problems,so as to achieve the ideal result.Methods Through the platform,558 referral samples with psychological development deviation and suspicious behavior problems,who transferred from 16 district-level early childhood development centers from November 9th,2018 to December 31st,2019 were enrolled in this study.And their related data on comprehensive intervention,regular monitoring and follow-up management provided by children's health center were analyzed to carry out practical research and support preliminary assessment of the platform.Results Totally 524 cases (93.91%) with psychological behavior problems were diagnosed in the children's health center,through the way of inner collaboration to complete the diagnostic development assessment,medical behavior observation and necessary examination of causes in 558 referral samples.The top four types of the confirmed cases included overall retardation (301,53.94%),language retardation (119,21.33%),autism spectrum disorders (61,10.93%) and motor development delay (29,5.20%).Regular follow-up indicated that 408 (77.86%) children received various forms of rehabilitation interventions in the health center and the district child development center,and the efficacy rate was 29.77%.Conclusion As a successful practice to optimize the model of children's mental health care,this platform fully integrates multi-level and multi-discipline medical resources,carries out efficient two-way referral,implements comprehensive intervention management,facilitates and benefits the people.