关键词: 基层医疗卫生机构, 社区卫生服务, 儿科, 儿童保健服务, 卫生资源, 医疗服务能力

Abstract: Background  The outbreak of influenza in the spring of 2018 revealed the vulnerability of the capability for delivering pediatric services in primary care system in China.Opinions on Strengthening the Reform and Development of Pediatric Healthcare Services issued in 2016 required that at least 1 general practitioner should be equipped to each township hospital or each community health facility to provide standardized essential pediatric medical care.Therefore，pediatric resources and capacity for delivering pediatric services in primary healthcare institutions deserve high concern.Objective  To study pediatric resources distribution and capacity for providing pediatric services in primary healthcare institutions in China.Methods   Data were collected from 2 volumes of China's Health Statistics Yearbook（2011—2012），5 volumes of China's Health and Family Planning Statistical Yearbook（2013—2017），and China's Hygiene and Health Statistical Yearbook 2018.Proportions of numbers of pediatric departments，pediatric beds，practising pediatric physicians（assistants），pediatric emergency visits，and pediatric discharges in primary healthcare institutions（including community and township health centers），and in healthcare institutions were analyzed.Results   In 2017，among all the community health centers，those delivering pediatric services accounted for 25.60%，and numbers of pediatric beds，practising pediatric physicians（physician assistants），pediatric emergency outpatient visits，and pediatric discharges owned by them accounted for 2.69% of the total beds，1.32% of the total physicians（physician assistants），2.73% of the total emergency outpatient visits，and 3.22% of the total discharges，respectively.During the same year，of all the township health centers，those offering pediatric services made up 50.84%，and numbers of pediatric beds，practising pediatric physicians（physician assistants），pediatric emergency outpatient visits，and pediatric discharges owned by them occupied 7.41% of the total beds，1.47% of the total physicians（physician assistants），7.64% of the total emergency outpatient visits，and 7.71% of the total discharges，respectively.During the period of 2010—2017，among all the primary healthcare institutions，the percentage of pediatric resources held by those delivering pediatric services and their capability level for delivering such services generally demonstrated year-over-year downward trends.Moreover，among all the healthcare institutions，the percentage of pediatric resources held by primary healthcare institutions delivering pediatric services and their capability level for delivering such services also showed year-over-year downward trends on the whole.Conclusion   The capability level for delivering pediatric services in primary healthcare institutions is unsatisfied.In view of this，improvement strategies are suggested as follows：incorporating the enhancement of pediatric resources allocation and pediatric service delivery capability in primary healthcare institutions into the overall health development programs of the local area，actively promoting the construction of pediatric alliance，increasing the pediatric service capacity level of general practitioners and introducing pediatric professionals to primary care when necessary，increasing the number and kinds of pediatric medicines in primary healthcare institutions and strengthening the guidance on safety of drug use in children.

Key words: Primary medical and health institutions, Community health services, Pediatrics, Child health services, Health resources, Medical service capability