Survey on intention of seeking pediatric care in community health center among residents in a rural area of Shanghai / 中华全科医师杂志

ABSTRACT

Objective To survey on the intention of seeking pediatric service in primary care institutions among parents in Shanghai rural area .Methods A survey on the intention of pediatric care-seeking was conducted during June to December in 2016 using simple random sampling method in Fengxian District of Shanghai.Subjects were choosen from the parents visiting pediatric department in Xidu Community Health Center ( CHC) (289 ), parents having kids in the local kindergarten ( 121), and medical staff working in this district with children under age 14 (205).Results Total 615 individuals were surveyed and 572 responded with a response rate of 93.0%.The age of participants was (32.1 ±6.4) years, and they were 191 males and 381 females.Among all responders, 88.4%(505/571) wanted to have pediatric service in CHC, 9.5%(54/571) did not care and 2.1%(12/571) did not want.If the CHC had service provided by pediatric specialists , 81.5%( 466/572) intended to seek pediatric care in CHC , 10.8%(62/572) did not care and 7.7%(44/572) did not want.If the general practitioner provided pediatric service, the rates were 51.9%(297/572), 12.1%(69/572) and 36.0%(206/572), respectively.In comparison, the intention to seek care provided by pediatric specialists was stronger (Z ＝-12.553, P ＜0.001). Parents who were not medical professionals preferred to set pediatric clinic in CHC ( OR ＝6.849, P ＝0.026); parents who were not Shanghai residents preferred to see pediatric specialists (OR＝2.732, P＝0.033).Parents who were older than 30 years (OR＝1.770, P＝0.013), who were medical professionals (OR＝2.093, P＝0.003) or having children aged 0-3 years (OR＝2.154, P＝0.001) preferred to visit general practice clinics .Only 11.7%(66/562) would choose CHC when their children were ill . Parents who were older than 30 years (OR＝2.083, P＝0.038) or whose family income was less than 8 000 yuan/m (OR＝1.967, P＝0.030) preferred to choose CHC.The reason for choosing CHC was close to home for 93.8%(61/65) and good treatment effect for only 18.5%(12/65).The expectations of pediatrics in CHC included more comprehensive medical equipment (82.2%, 466/567), higher service level (77.8%,441/567), more complete medicine stock (74.8%, 424/567)and regular expert outpatient service (70.0%, 397/567).Conclusion Parents have strong demands of providing pediatric care in CHC, but the pediatric skills of general practitioners are not trusted .The CHC should upgrade related facilities and medicine stock for further improving the quality of pediatric service .