目的研究家庭医生签约服务模式(家签模式)应用于儿童健康管理中对0～3岁儿童生长发育的作用,为探讨家庭医生服务与儿童健康管理工作相结合的新模式提供科学依据。方法以2017年2月-2019年2月在广州市天河区棠下街社区卫生服务中心儿童保健门诊儿保的0～3岁常住儿童为研究对象,随机抽取360名儿童进行队列研究。结果干预组儿童身长体重的平均增长值[W干预=(3.83±1.57)kg,h干预=(15.99±5.41) cm]均高于对照组儿童[W对照=(2.84±1.36) kg,h对照=(13.49±5.36)cm];干预组儿童在上、下呼吸道感染和小儿腹泻3种常见病发病人次数、病程和疾病治疗费用(包括医药费和检验费等)均少于对照组儿童;对照组儿童发生缺铁性贫血人数高于干预组儿童,其发生缺铁性贫血的危险性是干预组儿童的2.26倍;干预组满意度评价高于对照组。结论家签模式应用于儿童健康管理中有利于促进儿童生长发育,减少儿童常见病和缺铁性贫血的发生,提升家长对于社区基层医疗的信任度和满意度,进一步促进家庭医生签约服务的推广,利于社区卫生服务中心推行。

Objective To study the effect of family doctor contract service model on the growth and development of 0-3-year-old children in child health management, so as to provide a scientific basis for exploring the new model of the combination of family doctor service and child health management. study the role of family doctor contracting mode applied in children's health management service for the growth of children aged 0-3 years, and to provide a scientific basis for exploring the new model with combination of family doctor service and child health care project.Methods The resident children aged 0-3 years old rendered received health care in the child care clinic of the Tangxia Street Community Health Service Center from February 2017 to February 2019 were listed selected as research object, among which 360 children were randomly selected for cohort study.Results The average values of body weight and height of children in the intervention group(Wint=(3.83 ±1.57) kg,hint=(15.99 ±5.41) cm) were higher than those of the control group(Wcon=(2.84 ±1.36) kg,hcon=(13. 49 ± 5. 36)cm). In the intervention group, the incidence of the three common diseases of upper and lower respiratory tract infections, diarrhea and etc in children, whether the number of cases, the period of illness or the family bearing charges for disease treatment(including medical expenses and inspection fees, etc.) were also less than the control group of children; The number of patients, the course of disease and the cost of disease treatment(including medical expenses and test fees, etc.) of the three common diseases-upper and lower respiratory tract infection and infantile diarrhea in the intervention group were less than those in the control group. The number of children with iron deficiency anemia in the control group was higher than that in the intervention group, and the risk of iron deficiency anemia in the control group was 2.26 times higher than that in the intervention group. The number of children with nutritional iron deficiency anemia in the control group was higher than that of the intervention group, of which the risk of nutritional iron deficiency anemia was 2. 26 times of higher than that in the intervention group. The satisfaction evaluation of the intervention group was generally higher than that of the control group.Conclusion The application of family doctor contract model in children's health management is beneficial to promote children's growth and development, reduce the incidence of common diseases and iron deficiency anemia, and enhance parents' trust and satisfaction with community primary health care. Further promote the promotion of family doctor contract service, which is conducive to the implementation of community health service centers.