目的 了解儿童保健门诊就诊人群分布及常见疾病种类变化趋势,为优化儿童保健服务资源配置及提高疾病的管理水平提供依据。方法 采用横断面研究,从医院信息系统采集2019—2024年首都医科大学附属北京儿童医院保健门诊就诊所有儿童诊疗信息。采用描述性、Pearson相关性及线性趋势性χ2检验等统计方法,分析不同年度就诊儿童主诉、确诊疾病构成比差异及变化趋势。结果 2019—2024年,儿童保健中心就诊人次呈波动上升趋势,2024年较2019年增长51.5%。这6年中,<3岁儿童占比最高(44.4%)。2019—2022年,生长与营养门诊就诊人次均居首位(平均占比38.0%),2023—2024年,发育行为门诊跃居首位(平均占比40.8%)。在生长与营养门诊中,家长关注首位问题由2019—2020年的“营养与喂养”(平均42.4%)转变为2021—2024年的“身高”(平均40.6%);6年间,家长对生长迟缓/身材矮小症的疾病认知与医生临床诊断符合率显著下降(χ2=58.622,P<0.001)。在发育行为门诊中,2019—2023年家长关注的前两位问题终始为语言言语和发育迟缓;2024年“注意力问题”升至家长关注第二位(29.9%);6年间家长对发育行为问题的认知与诊断符合率亦显著下降(χ2=19.528,P<0.001)。结论 6年来,家长对儿童身高、发育行为的认知与医生临床诊断符合率呈下降趋势,提示儿童保健医生需具备多学科知识以应对儿童健康管理需求并缓解家长育儿焦虑。
Abstract
Objective To analyze the distribution of outpatient visits and trends in common diseases within a children's health care center, in order to provide a scientific basis for optimizing pediatric health services and improving disease management. Methods A cross-sectional study was conducted using data from the Hospital Information System of the Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, from 2019 to 2024. Descriptive statistics, Pearson correlation analysis, and linear trend χ2 tests were employed to analyze the composition of chief complaints, diagnosed diseases, and their changing trends across different years. Results The total number of outpatient visits fluctuated but showed an overall upward trend from 2019 to 2024, with a 51.5% increase in 2024 compared to 2019. Children under 3 years old accounted for the largest proportion (44.4%) over the six years. The Growth and Nutrition Clinic ranked first in visit volume from 2019 to 2022 (average proportion: 38.0%), whereas the Development and Behavior Clinic took the lead in 2023—2024 (average proportion: 40.8%). In the Growth and Nutrition Clinic, parents' primary concern shifted from "nutrition and feeding" (average 42.4%) in 2019—2020 to "height" (average 40.6%) in 2021—2024. Over the six years, the concordance rate between parents' perception of stunting/short stature and clinical diagnosis significantly decreased (χ2=58.622, P<0.001). In the Development and Behavior Clinic, "language/speech problems" and "developmental delay" were the top two parental concerns from 2019 to 2023. However, in 2024, "attention issues" emerged as the second most common concern (29.9%). Similarly, the concordance rate between parents' perception of developmental behavioral issues and clinical diagnosis significantly declined over the period (χ2=19.528, P<0.001). Conclusions Over the past six years, there has been a notable increase in parental concern regarding children's height and developmental behaviors (such as attention). However, the declining concordance rate between parental perception and clinical diagnosis suggests a prevalence of parental anxiety or cognitive bias. This underscores the need for pediatric health professionals to possess multidisciplinary knowledge to effectively address children's health management needs and alleviate parental child-rearing anxiety.
关键词
儿童保健 /
人群分布 /
趋势分析
Key words
children's health care /
population distribution /
trend analysis
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