目的 了解托育机构医育结合服务开展情况，并探索可能的影响因素，为后续更好地开展医育结合工作、促进集体婴幼儿健康提供依据。方法 2024年5—9月，采用分层随机抽样方法，在国家卫生健康委备案托育机构名单中抽取27个省(自治区、直辖市)共1 360所托育机构，通过线上问卷调查方法，对托育机构的医育结合工作进行调查。结果 66.2%的托育机构与医疗卫生机构合作开展医育结合服务，合作的医疗卫生机构主要为妇幼保健机构和社区卫生服务中心，分别为36.0%和26.1%；医育结合服务开展率东部地区>中部地区>西部地区，分别为70.7%、67.2%和61.6%，不同地区间差异有统计学意义(χ²=8.426,P=0.015)。已经开展医育结合服务的托育机构中，57.0%开展3～5项服务；主要服务内容包括定期体检、人员培训、健康教育和现场技术指导，开展比例分别为87.7%、79.5%、77.0%和57.0%；不同医疗卫生机构提供服务内容在婴幼儿定期体检服务、保育人员培训、人员派驻和中医适宜技术引入上的差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示，东部地区、公办类型、2022年8月前备案、普惠是托育机构开展医育结合服务的保护因素；未进行卫生评价是开展医育结合服务的不利因素。结论 各地托育机构在积极尝试与医疗卫生机构合作开展医育结合服务，针对新备案、民办、非普惠和未进行卫生评价的托育机构要加强医育结合服务工作的指导。

Objective To understand the status of health and nursery integration services in childcare institutions and explore its potential influencing factors,and to provide a basis for better conducting health and nursery integration services in the future.Methods From May to September 2024,a stratified random sampling method was used to select 1 360 childcare institutions from 27 provinces (regions,municipalities) in the list of childcare institutions filed with the National Health Commission.A questionnaire survey was conducted to investigate the health and nursery integration services in these childcare institutions.Results Among the1 360 childcare institutions,66.2% cooperated with medical institutions to carry out health and nursery integration service.The main cooperating medical and health institutions were maternal and child health care institutions and community health service centers,accounting for 36.0% and 26.1%,respectively.The rate of health and nursery integration service implementation was higher in the eastern region than in the central and western regions,with rates of 70.7%,67.2%,and 61.6%,respectively (χ²=8.426,P=0.015).Among the childcare institutions that had implemented health and nursery integration service,57% offered 3 to 5 types of services.The main service contents included regular physical examinations,personnel training,health education,and on-site technical guidance,with implementation rates of 87.7%,79.5%,77.0%,and 57.0%,respectively.There were statistically significant differences in the service contents provided by different medical and health institutions in terms of regular physical examinations for children,training of caregivers,personnel deployment,and the introduction of traditional Chinese medicine techniques (P<0.05).Multivariate logistic regression analysis showed that eastern region,public ownership,filing before August 2022,and being inclusive were protective factors for childcare institutions to carry out health and nursery integration services,while not conducting health evaluation was an adverse influencing factor.Conclusion Childcare institutions in various regions are actively trying to cooperate with medical and health institutions to carry out health and nursery integration services.It is necessary to strengthen the guidance of medical-care integration work for newly filed,privately owned,non-inclusive childcare institutions,and those that have not conducted health evaluations.