Page 33 - 2023-01-中国全科医学

·28· http: //www.chinagp.net E-mail: zgqkyx@chinagp.net.cn January 2023, Vol.26 No.1

Methods In November 2021，data about health management of children under three years old in China during 2011—2020
were extracted from 10 volumes of China Health Statistics Yearbook published annually from 2011 to 2020. A descriptive analysis
was used to conduct temporal and geographical analysis of the systematic health management for children. Results As a whole，
the national health management rate for children under three years old showed a continuous upward trend increased from 81.5%
in 2010 to 91.9% in 2019，with a 12.8% increase. The annual rate of systematic health management of the children during
the period was greater than 90.0% in Beijing，Inner Mongolia Autonomous Region，Liaoning Province，Shanghai，Jiangsu
Province，Zhejiang Province，Shandong Province，Guangdong Province and Shaanxi Province，but was relatively low in the
Tibet Autonomous Region（71.9% in 2019），indicating that there was still a certain gap between the local level and policy goals
in this region. The analysis from temporal changes and regional differences as well as regional perspective revealed the following
findings：the rate of systematic health management for children under three years during 2010—2019 was higher than the national
level in 13（41.9%）out of 31 regions in China，lower than the national level in 7 regions（22.6%），and moved around
the national level in 11 regions（35.5%）. The systematic health management rate of children under 3 years old varied greatly
between regions during 2010—2012，but the inter-regional differences gradually narrowed after 2015. The rate of systematic
health management for children under 3 years old was the highest in northeast China，followed by eastern China，western China
and central China. In 2019，there was still large differences in the rate of systematic health management for these children among
regions in western China. Conclusion China has achieved remarkable results in systematic health management for children under
3 years old. More attention should be given to the regions in western China，especially the Tibet Autonomous Region during the
improvement of the management for these children. To further improve and consolidate the health management level of children，
it is suggested to make efforts to improve the equity and accessibility of essential medical services，narrow the inter-regional
differences between health resource allocation and public health services，learn and apply relevant good management methods
from advanced regions，make full use of big data and internet techniques，and strengthen the construction of community pediatric
health management team.
【Key words】 Children under three years old；System management for children；Vertical change；Horizontal
difference；Child health services；Community health services

0~3 岁是儿童大脑发育与能力发展的敏感期、最佳 儿童系统管理率进行分析，力求把握 3 岁以下儿童系统
期 ［1］ 。这一时期是儿童可塑性最强的时期，也是儿童 管理水平的纵向变动与横向差异，了解地区间 3 岁以下
体格生长、智力发育、性格形成、良好行为习惯养成 儿童系统管理率的差异及各地 3 岁以下儿童系统管理率
的关键时期，又被称为“机会窗口期” ［2］ 。相关研究 的发展变化趋势、达标情况，明确不同地区 3 岁以下儿
结果表明，0~3 岁这一阶段是个人全面发展的开端，为 童系统管理工作的目标和重点，旨在为各地落实《“健
个人一生的健康与发展奠定了基础 ［3］ 。若儿童在 0~3 康中国 2030”规划纲要》中提出的“力争到 2030 年人
岁这一阶段未得到充分发展，不仅会影响其儿童期健 人享有全方位、全生命周期的健康服务”这一要求，以
康，还会影响其成年期健康和对疾病的敏感性 ［4］ 。考 及实现《健康儿童行动提升计划（2021—2025 年）》（国
虑到 0~3 岁是人力资本的投资回报率最高的阶段 ［5］ ， 卫妇幼发〔2021〕33 号）、《中国儿童发展纲要（2021—
因此，对 3 岁以下儿童这一社会上较为“柔软”的群体 2030 年）》（国发〔2021〕16 号）中提出的 3 岁以下
进行整体、全面、连续的健康管理，即系统管理 ［6］ ， 儿童系统管理率目标提供有益的借鉴，最终助力我国儿
具有必要性、重要性和合理性 ［7］ 。既往研究发现，对 童健康水平的提升。
3 岁以下儿童进行系统管理不仅有利于提高儿童健康水 1 资料与方法
平，保障其生命质量，降低婴幼儿常见病的发病率、死 1.1 数据来源与变量界定 于 2021 年 11 月，以
亡率和残疾率，还有助于促进其早期生长、智力和运 2011—2020 年《中国卫生健康统计年鉴》作为数据来
动发育 ［8］ 。同时 3 岁以下儿童系统管理工作的开展与 源，提取 2010—2019 年 3 岁以下儿童系统管理率数
落实情况也一定程度上反映了一个地区经济社会及公 据。根据《中华人民共和国卫生行业标准 WS/T 598.5—
共服务的发展水平 ［9］ 。在 20 世纪 80 年代，我国许多 2018》：“3 岁以下儿童系统管理率”指的是一定时期
地区已经开展了儿童系统管理工作 ［10］ ；2009 年开始， 内某地区 3 岁以下儿童中接受系统管理的人数所占百
3 岁以下儿童的健康管理被纳入我国基本公共卫生服 分比，即 3 岁以下儿童系统管理率 = 报告期内某地区 3
务项目 ［11］ ，其中儿童系统管理率是一项重要的考核指 岁以下儿童系统管理人数 / 同期该地区 3 岁以下儿童数
标 ［12］ 。本研究通过对 2010—2019 年十年间 3 岁以下 ×100%。3 岁以下儿童系统管理人数指的是报告期内 3