Article(id=1324044794015658934, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512085, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1764777600000, receivedDateStr=2025-12-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606478455, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606478455, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606478455, creator=13701087609, updateTime=1793606478455, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1866, endPage=1872, ext={EN=ArticleExt(id=1324044794279900088, articleId=1324044794015658934, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the current status and variations in integrated medical and childcare services within infant care institutions,Guizhou, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current state of integrated medical and childcare services in Guizhou Province’s childcare institutions and propose corresponding countermeasures and recommendations.

Methods

A cross-sectional study was conducted, involving a questionnaire survey of 574 registered childcare institutions in Guizhou Province. Differences across various types of childcare institutions were examined across three dimensions: childcare provision, health and hygiene, and parenting support.

Results

With regard to childcare and care, the compliance rate for the cumulative duration of daily outdoor activities at the centre was low, with significant differences between institutions(P<0.001). However, services such as sleep monitoring, the frequency of menu changes, and the setting of individualised development goals based on physical and mental development were generally well implemented, with no significant differences between institutions(P>0.05). The rate of regular disinfection of bedding was low, with no significant differences between institutions(P>0.05). In terms of health care:(1) The development of health care systems was inadequate, and there were significant differences between institutions(P=0.015);(2) The implementation rates for physical growth and development monitoring(P=0.002), oral health care(P=0.005) and eye care services(P<0.001) were relatively high, whilst those for psychological and behavioural assessments(P=0.012) and traditional Chinese medicine health care services(P=0.004) were relatively low, with significant differences observed between institutions(P<0.05); Conversely, the rate of establishing individual health management records was high, with no significant differences between institutions(P>0.05), whilst the rate of provision of first-aid supplies for accidental injuries was low, with no significant differences between institutions(P>0.05). Regarding parenting support, more than half of the institutions received medical guidance, and there was a widespread need for family parenting support and policy interpretation, with no significant differences between institutions(P>0.05); however, there was a significant difference in whether institutions that received medical guidance were able to meet infant and child health care needs(P=0.033).

Conclusion

Childcare institutions across Guizhou Province have implemented integrated medical and childcare services to varying degrees, though the standardisation and professionalism of these services remain areas for improvement. The government should expedite the formulation of local standards for integrated medical and childcare services and actively advance the “1+4+N” service model to foster high-quality development in childcare provision.

, authors=Yan-fang TANG1, Yang HONG1, 2, Feng HONG1, Qin-ying LONG2, Tian-lin ZHANG2, Yuan CHEN2, Yan LUO3, authorsList=Yan-fang TANG, Yang HONG, Feng HONG, Qin-ying LONG, Tian-lin ZHANG, Yuan CHEN, Yan LUO, authorCompany=null, correspAuthors=Yang HONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044794753856443, articleId=1324044794015658934, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=贵州省托育机构医育结合服务现状及差异分析, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的

了解贵州省托育机构医育结合服务现状,并提出对策建议。

方法

采用横断面研究,对贵州省已备案574家托育机构开展问卷调查。比较不同类型托育机构在保育照护、卫生保健和养育支持三个维度的差异。

结果

在保育照护方面,每日在园户外累计活动时长达标率较低,机构间差异显著(P<0.001),睡眠巡视照护、食谱更换频率及依据身心发展特点制定个体化发展目标等服务开展较好,机构间无显著差异(P>0.05);睡眠用具是否定期消毒执行率偏低,机构间无显著差异(P>0.05)。在卫生保健方面:(1)卫生保健制度建设不够完善且机构间的差异显著(P=0.015);(2)体格生长发育监测(P=0.002)、口腔保健(P=0.005)及眼保健服务(P<0.001)开展率较高,心理行为评估(P=0.012)与中医保健服务(P=0.004)开展率较低,机构间差异均显著(P<0.05);而建立个体健康管理档案服务率较高,机构间无显著差异(P>0.05),意外伤害急救物资配备率较低,机构间无显著差异(P>0.05)。养育支持方面,获得医疗指导超过半数以上、提供家庭养育支持及政策解读需求普遍,机构间无显著差异(P>0.05),但获得医疗指导的机构能否满足婴幼儿保健需求方面差异显著(P=0.033)。

结论

贵州省托育机构均不同程度开展医育结合服务实践,但服务规范性与专业性仍有待提升。政府应加快制定地方性医育结合标准,切实推进“1+4+N”服务模式,以促进托育服务高质量发展。

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唐艳芳(1998—),女,硕士在读,研究方向:妇幼保健与人口健康,托育服务

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洪阳,E-mail:
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(In Chinese), articleTitle=Survey on the status of health and nursery integration services and its influencing factors in 1 360 childcare institutions, refAbstract=null), Reference(id=1324045115823620886, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2026, volume=28, issue=1, pageStart=32, pageEnd=40, url=null, language=null, rfNumber=[14], rfOrder=26, authorNames=尹婷, 湛中乐, journalName=河北师范大学学报:教育科学版, refType=null, unstructuredReference=尹婷,湛中乐.我国托育服务立法的现状、问题与应对[J]. 河北师范大学学报:教育科学版,2026, 28(1):32-40., articleTitle=我国托育服务立法的现状、问题与应对, refAbstract=null), Reference(id=1324045115907506967, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2026, volume=28, issue=1, pageStart=32, pageEnd=40, url=null, language=null, rfNumber=[14], rfOrder=27, authorNames=Yin T, Zhan ZL, journalName=Journal of Hebei Normal University(Educational Science Edition), refType=null, unstructuredReference=Yin T, Zhan ZL. Legislative safeguards for childcare services in China:current status, challenges, and institutional responses[J]. Journal of Hebei Normal University(Educational Science Edition), 2026, 28(1): 32-40. (In Chinese), articleTitle=Legislative safeguards for childcare services in China:current status, challenges, and institutional responses, refAbstract=null), Reference(id=1324045116075279128, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=22, pageStart=4119, pageEnd=4125, url=null, language=null, rfNumber=[15], rfOrder=28, authorNames=邓长飞, 蒲杰, 乔牧天, journalName=现代预防医学, refType=null, unstructuredReference=邓长飞,蒲杰,乔牧天,等. 四川省托育服务人才队伍建设现状分析及对策研究[J]. 现代预防医学,2025, 52(22):4119-4125., articleTitle=四川省托育服务人才队伍建设现状分析及对策研究, refAbstract=null), Reference(id=1324045116171748121, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=22, pageStart=4119, pageEnd=4125, url=null, language=null, rfNumber=[15], rfOrder=29, authorNames=Deng CF, Pu J, Qiao MT, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Deng CF, Pu J, Qiao MT, et al. Research on the status of talent team construction and countermeasures of childcare workers, Sichuan[J]. Modern Preventive Medicine, 2025, 52(22): 4119-4125. (In Chinese), articleTitle=Research on the status of talent team construction and countermeasures of childcare workers, Sichuan, refAbstract=null), Reference(id=1324045116259828506, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2024, volume=38, issue=5, pageStart=30, pageEnd=36, url=null, language=null, rfNumber=[16], rfOrder=30, authorNames=洪秀敏, 张明珠, 刘倩倩, journalName=北京教育学院学报, refType=null, unstructuredReference=洪秀敏,张明珠,刘倩倩.托育机构保育人员专业素养水平、类型及影响因素——来自全国12省份的调研数据[J]. 北京教育学院学报,2024, 38(5):30-36., articleTitle=托育机构保育人员专业素养水平、类型及影响因素——来自全国12省份的调研数据, refAbstract=null), Reference(id=1324045116490515227, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2024, volume=38, issue=5, pageStart=30, pageEnd=36, url=null, language=null, rfNumber=[16], rfOrder=31, authorNames=Hong XM, Zhang MZ, Liu QQ, journalName=Journal of Beijing Institute of Education, refType=null, unstructuredReference=Hong XM, Zhang MZ, Liu QQ. Levels, types and influencing factors of the professional competence of caregivers in childcare institutions——data from 12 provinces in China[J]. Journal of Beijing Institute of Education, 2024, 38(5): 30-36. (In Chinese), articleTitle=Levels, types and influencing factors of the professional competence of caregivers in childcare institutions——data from 12 provinces in China, refAbstract=null), Reference(id=1324045116557624092, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2025, volume=43, issue=5, pageStart=14, pageEnd=18, url=null, language=null, rfNumber=[17], rfOrder=32, authorNames=夏利华, 任柳, journalName=卫生职业教育, refType=null, unstructuredReference=夏利华,任柳.婴幼儿托育服务与管理专业“医养教协同”产教融合培养模式实践研究[J]. 卫生职业教育,2025, 43(5):14-18., articleTitle=婴幼儿托育服务与管理专业“医养教协同”产教融合培养模式实践研究, refAbstract=null), Reference(id=1324045116628927261, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2025, volume=43, issue=5, pageStart=14, pageEnd=18, url=null, language=null, rfNumber=[17], rfOrder=33, authorNames=Xia LH, Ren L, journalName=Health Vocational Education, refType=null, unstructuredReference=Xia LH, Ren L. Research on the practice of integration of industry and education training model of "Treatment-Nursing-Education collaboration" in the major of infant and child care services and management[J]. Health Vocational Education, 2025, 43(5): 14-18. (In Chinese), articleTitle=Research on the practice of integration of industry and education training model of "Treatment-Nursing-Education collaboration" in the major of infant and child care services and management, refAbstract=null), Reference(id=1324045116704424734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2026, volume=53, issue=4, pageStart=657, pageEnd=661, 726, url=null, language=null, rfNumber=[18], rfOrder=34, authorNames=张唯娜, 冯频, 周南, journalName=现代预防医学, refType=null, unstructuredReference=张唯娜,冯频,周南,等. 湖南省医育结合服务发展现状:医疗机构与托育机构的供需特征研究[J]. 现代预防医学,2026, 53(4):657-661, 726., articleTitle=湖南省医育结合服务发展现状:医疗机构与托育机构的供需特征研究, refAbstract=null), Reference(id=1324045116779922207, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, doi=null, pmid=null, pmcid=null, year=2026, volume=53, issue=4, pageStart=657, pageEnd=661, 726, url=null, language=null, rfNumber=[18], rfOrder=35, authorNames=Zhang WN, Feng P, Zhou N, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Zhang WN, Feng P, Zhou N, et al. The current status of integrated medical and childcare services in Hunan Province:A study on the supply and demand characteristics of medical institutions and childcare facilities[J]. Modern Preventive Medicine, 2026, 53(4): 657-661, 726. (In Chinese), articleTitle=The current status of integrated medical and childcare services in Hunan Province:A study on the supply and demand characteristics of medical institutions and childcare facilities, refAbstract=null)], funds=[Fund(id=1324045112740807417, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, awardId=gzwkj2022-199, language=CN, fundingSource=贵州省卫生健康委科学技术基金项目(gzwkj2022-199), fundOrder=null, country=null), Fund(id=1324045112845665018, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, awardId=gzhlyj2024-03, language=CN, fundingSource=贵州护理职业技术学院院级课题(gzhlyj2024-03), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324045107204326076, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, xref=1., ext=[AuthorCompanyExt(id=1324045107216908989, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, companyId=1324045107204326076, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Guiyang, Guizhou 561113, China), AuthorCompanyExt(id=1324045107225297598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, companyId=1324045107204326076, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113)]), AuthorCompany(id=1324045107309183679, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, xref=2., ext=[AuthorCompanyExt(id=1324045107321766592, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, companyId=1324045107309183679, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵州护理职业技术学院)]), AuthorCompany(id=1324045107430818497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, xref=3., ext=[AuthorCompanyExt(id=1324045107439207106, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, companyId=1324045107430818497, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.贵阳市妇幼保健院儿童保健科)])], figs=[ArticleFig(id=1324045111054697199, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=EN, label=Table 1, caption=

Childcare provision at 574 nurseries[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
每日在园户外累计活动时间<0.001
≥2 h21(87.50)245(62.50)123(80.39)5(100.00)394(68.64)
<2 h3(12.50)147(37.50)30(19.61)0(0.00)180(31.36)
睡眠用具是否定期消毒0.124
是8(33.33)122(31.12)35(22.88)0(0.00)165(28.75)
否16(66.67)270(68.88)118(77.12)5(100.00)409(71.25)
睡眠巡视照护0.626
有24(100.00)389(99.23)153(100.00)5(100.00)571(99.48)
无0(0.00)3(0.77)0(0.00)0(0.00)3(0.52)
食谱更换频率0.286
每周更新23(95.83)356(90.82)146(95.42)5(100.00)530(92.33)
非每周更新1(4.17)36(9.18)7(4.58)0(0.00)44(7.67)
根据婴幼儿身心发展特点制定个体化发展目标0.200
是24(100.00)373(95.15)151(98.69)5(100.00)553(96.34)
否0(0.00)19(4.85)2(1.31)0(0.00)21(3.66)
), ArticleFig(id=1324045111159554800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=CN, label=表1, caption=

574家托育机构保育照护情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
每日在园户外累计活动时间<0.001
≥2 h21(87.50)245(62.50)123(80.39)5(100.00)394(68.64)
<2 h3(12.50)147(37.50)30(19.61)0(0.00)180(31.36)
睡眠用具是否定期消毒0.124
是8(33.33)122(31.12)35(22.88)0(0.00)165(28.75)
否16(66.67)270(68.88)118(77.12)5(100.00)409(71.25)
睡眠巡视照护0.626
有24(100.00)389(99.23)153(100.00)5(100.00)571(99.48)
无0(0.00)3(0.77)0(0.00)0(0.00)3(0.52)
食谱更换频率0.286
每周更新23(95.83)356(90.82)146(95.42)5(100.00)530(92.33)
非每周更新1(4.17)36(9.18)7(4.58)0(0.00)44(7.67)
根据婴幼儿身心发展特点制定个体化发展目标0.200
是24(100.00)373(95.15)151(98.69)5(100.00)553(96.34)
否0(0.00)19(4.85)2(1.31)0(0.00)21(3.66)
), ArticleFig(id=1324045111251829489, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=EN, label=Table 2, caption=

Establishment of healthcare systems in 574 childcare facilities[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组完善
(n=467)
不完善
(n=107)
总计
(n=574)
P
公办托育园24(100.00)0(0.00)24
民办托育园309(78.83)83(21.17)392
幼儿园托育班130(84.97)23(15.03)1530.015
企业配套托育4(80.00)1(20.00)5
总计467(81.36)107(18.64)574
), ArticleFig(id=1324045111482516210, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=CN, label=表2, caption=

574家托育机构卫生保健制度建设情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组完善
(n=467)
不完善
(n=107)
总计
(n=574)
P
公办托育园24(100.00)0(0.00)24
民办托育园309(78.83)83(21.17)392
幼儿园托育班130(84.97)23(15.03)1530.015
企业配套托育4(80.00)1(20.00)5
总计467(81.36)107(18.64)574
), ArticleFig(id=1324045111604151027, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=EN, label=Table 3, caption=

Health care services in 574 childcare facilities[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
建立个体健康管理档案0.960
有22(91.67)351(89.54)139(90.85)5(100.00)517(90.07)
无2(8.33)41(10.46)14(9.15)0(0.00)57(9.93)
体格生长发育监测服务0.002
有24(100.00)300(76.53)131(85.62)5(100.00)460(80.14)
无0(0.00)92(23.47)22(14.38)0(0.00)114(19.86)
心理行为发育评估服务0.012
有17(70.83)208(53.06)72(47.06)0(0.00)297(51.74)
无7(29.17)184(46.94)81(52.94)5(100.00)277(48.26)
开展中医保健服务0.004
有8(33.33)56(14.29)11(7.19)0(0.00)75(13.07)
无16(66.67)336(85.71)142(92.81)5(100.00)499(86.93)
在园每天累计观看电子屏幕时间0.852
≤30分钟24(100.00)372(94.90)146(95.42)5(100.00)547(95.30)
>30分钟0(0.00)20(5.10)7(4.58)0(0.00)27(4.70)
开展眼保健服务<0.001
有23(95.83)256(65.31)114(74.51)3(60.00)396(68.99)
无1(4.17)136(34.69)39(25.49)2(40.00)178(31.01)
开展口腔保健服务0.005
有23(95.83)297(75.77)132(86.27)4(80.00)456(79.44)
无1(4.17)95(24.23)21(13.73)1(20.00)118(20.56)
意外伤害急救物资配备情况0.435
有1(4.17)52(13.27)15(9.80)0(0.00)68(11.85)
无23(95.83)340(86.73)138(90.20)5(100.00)506(88.15)
), ArticleFig(id=1324045111880975092, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=CN, label=表3, caption=

574家托育机构卫生保健服务情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
建立个体健康管理档案0.960
有22(91.67)351(89.54)139(90.85)5(100.00)517(90.07)
无2(8.33)41(10.46)14(9.15)0(0.00)57(9.93)
体格生长发育监测服务0.002
有24(100.00)300(76.53)131(85.62)5(100.00)460(80.14)
无0(0.00)92(23.47)22(14.38)0(0.00)114(19.86)
心理行为发育评估服务0.012
有17(70.83)208(53.06)72(47.06)0(0.00)297(51.74)
无7(29.17)184(46.94)81(52.94)5(100.00)277(48.26)
开展中医保健服务0.004
有8(33.33)56(14.29)11(7.19)0(0.00)75(13.07)
无16(66.67)336(85.71)142(92.81)5(100.00)499(86.93)
在园每天累计观看电子屏幕时间0.852
≤30分钟24(100.00)372(94.90)146(95.42)5(100.00)547(95.30)
>30分钟0(0.00)20(5.10)7(4.58)0(0.00)27(4.70)
开展眼保健服务<0.001
有23(95.83)256(65.31)114(74.51)3(60.00)396(68.99)
无1(4.17)136(34.69)39(25.49)2(40.00)178(31.01)
开展口腔保健服务0.005
有23(95.83)297(75.77)132(86.27)4(80.00)456(79.44)
无1(4.17)95(24.23)21(13.73)1(20.00)118(20.56)
意外伤害急救物资配备情况0.435
有1(4.17)52(13.27)15(9.80)0(0.00)68(11.85)
无23(95.83)340(86.73)138(90.20)5(100.00)506(88.15)
), ArticleFig(id=1324045111998415605, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=EN, label=Table 4, caption=

Childcare facilities receiving parenting support guidance from healthcare institutions (373 facilities)[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=20)
民办托育园
(n=251)
幼儿园托育班
(n=97)
企业配套托育
(n=5)
总计
(n=373)
P
指导照护内容是否满足需求0.033
是18(90.00)246(98.01)94(96.91)4(80.00)362(97.05)
否2(10.00)5(1.99)3(3.09)1(20.00)11(2.95)
), ArticleFig(id=1324045112124244726, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=CN, label=表4, caption=

373家有医疗卫生机构指导托育机构养育支持情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=20)
民办托育园
(n=251)
幼儿园托育班
(n=97)
企业配套托育
(n=5)
总计
(n=373)
P
指导照护内容是否满足需求0.033
是18(90.00)246(98.01)94(96.91)4(80.00)362(97.05)
否2(10.00)5(1.99)3(3.09)1(20.00)11(2.95)
), ArticleFig(id=1324045112237490935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=EN, label=Table 5, caption=

Childcare support provision in 574 nurseries[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
医疗卫生机构对本机构开展指导0.087
是20(83.33)251(64.03)97(63.40)5(100.00)373(64.98)
否4(16.67)141(35.97)56(36.60)0(0.00)201(35.02)
机构向家庭提供养育支持0.709
是24(100.00)389(99.23)151(98.69)5(100.00)569(99.13)
否0(0.00)3(0.77)2(1.31)0(0.00)5(0.87)
是否需要对国家出台的“医育”相关文件进行深度培训1.000
是23(95.83)370(94.39)145(94.77)5(100.00)543(94.60)
否1(4.17)22(5.61)8(5.23)0(0.00)31(5.40)
), ArticleFig(id=1324045112371708664, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044794015658934, language=CN, label=表5, caption=

574家托育机构养育支持情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
分组公办托育园
(n=24)
民办托育园
(n=392)
幼儿园托育班
(n=153)
企业配套托育
(n=5)
总计
(n=574)
P
医疗卫生机构对本机构开展指导0.087
是20(83.33)251(64.03)97(63.40)5(100.00)373(64.98)
否4(16.67)141(35.97)56(36.60)0(0.00)201(35.02)
机构向家庭提供养育支持0.709
是24(100.00)389(99.23)151(98.69)5(100.00)569(99.13)
否0(0.00)3(0.77)2(1.31)0(0.00)5(0.87)
是否需要对国家出台的“医育”相关文件进行深度培训1.000
是23(95.83)370(94.39)145(94.77)5(100.00)543(94.60)
否1(4.17)22(5.61)8(5.23)0(0.00)31(5.40)
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贵州省托育机构医育结合服务现状及差异分析
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唐艳芳 1 , 洪阳 1, 2 , 洪峰 1 , 龙琴英 2 , 张畑霖 2 , 陈媛 2 , 骆艳 3
现代预防医学 | 卫生政策与管理 2026,53(10): 1866-1872
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现代预防医学 |卫生政策与管理 2026 , 53 (10) : 1866 -1872
贵州省托育机构医育结合服务现状及差异分析
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唐艳芳1, 洪阳1, 2 , 洪峰1, 龙琴英2, 张畑霖2, 陈媛2, 骆艳3
作者信息
  • 1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
  • 2.贵州护理职业技术学院
  • 3.贵阳市妇幼保健院儿童保健科
通讯作者:
洪阳,E-mail:
作者简介:

唐艳芳(1998—),女,硕士在读,研究方向:妇幼保健与人口健康,托育服务

Analysis of the current status and variations in integrated medical and childcare services within infant care institutions,Guizhou
Yan-fang TANG1, Yang HONG1, 2 , Feng HONG1, Qin-ying LONG2, Tian-lin ZHANG2, Yuan CHEN2, Yan LUO3
Affiliations
  • Key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Guiyang, Guizhou 561113, China
出版时间: 2026-05-25 doi: 10.20043/j.cnki.MPM.202512085
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目的

了解贵州省托育机构医育结合服务现状,并提出对策建议。

方法

采用横断面研究,对贵州省已备案574家托育机构开展问卷调查。比较不同类型托育机构在保育照护、卫生保健和养育支持三个维度的差异。

结果

在保育照护方面,每日在园户外累计活动时长达标率较低,机构间差异显著(P<0.001),睡眠巡视照护、食谱更换频率及依据身心发展特点制定个体化发展目标等服务开展较好,机构间无显著差异(P>0.05);睡眠用具是否定期消毒执行率偏低,机构间无显著差异(P>0.05)。在卫生保健方面:(1)卫生保健制度建设不够完善且机构间的差异显著(P=0.015);(2)体格生长发育监测(P=0.002)、口腔保健(P=0.005)及眼保健服务(P<0.001)开展率较高,心理行为评估(P=0.012)与中医保健服务(P=0.004)开展率较低,机构间差异均显著(P<0.05);而建立个体健康管理档案服务率较高,机构间无显著差异(P>0.05),意外伤害急救物资配备率较低,机构间无显著差异(P>0.05)。养育支持方面,获得医疗指导超过半数以上、提供家庭养育支持及政策解读需求普遍,机构间无显著差异(P>0.05),但获得医疗指导的机构能否满足婴幼儿保健需求方面差异显著(P=0.033)。

结论

贵州省托育机构均不同程度开展医育结合服务实践,但服务规范性与专业性仍有待提升。政府应加快制定地方性医育结合标准,切实推进“1+4+N”服务模式,以促进托育服务高质量发展。

婴幼儿照护服务  /  儿童保健  /  医育结合
Objective

To understand the current state of integrated medical and childcare services in Guizhou Province’s childcare institutions and propose corresponding countermeasures and recommendations.

Methods

A cross-sectional study was conducted, involving a questionnaire survey of 574 registered childcare institutions in Guizhou Province. Differences across various types of childcare institutions were examined across three dimensions: childcare provision, health and hygiene, and parenting support.

Results

With regard to childcare and care, the compliance rate for the cumulative duration of daily outdoor activities at the centre was low, with significant differences between institutions(P<0.001). However, services such as sleep monitoring, the frequency of menu changes, and the setting of individualised development goals based on physical and mental development were generally well implemented, with no significant differences between institutions(P>0.05). The rate of regular disinfection of bedding was low, with no significant differences between institutions(P>0.05). In terms of health care:(1) The development of health care systems was inadequate, and there were significant differences between institutions(P=0.015);(2) The implementation rates for physical growth and development monitoring(P=0.002), oral health care(P=0.005) and eye care services(P<0.001) were relatively high, whilst those for psychological and behavioural assessments(P=0.012) and traditional Chinese medicine health care services(P=0.004) were relatively low, with significant differences observed between institutions(P<0.05); Conversely, the rate of establishing individual health management records was high, with no significant differences between institutions(P>0.05), whilst the rate of provision of first-aid supplies for accidental injuries was low, with no significant differences between institutions(P>0.05). Regarding parenting support, more than half of the institutions received medical guidance, and there was a widespread need for family parenting support and policy interpretation, with no significant differences between institutions(P>0.05); however, there was a significant difference in whether institutions that received medical guidance were able to meet infant and child health care needs(P=0.033).

Conclusion

Childcare institutions across Guizhou Province have implemented integrated medical and childcare services to varying degrees, though the standardisation and professionalism of these services remain areas for improvement. The government should expedite the formulation of local standards for integrated medical and childcare services and actively advance the “1+4+N” service model to foster high-quality development in childcare provision.

Infant and child care services  /  Child health  /  Integration of health and education
唐艳芳, 洪阳, 洪峰, 龙琴英, 张畑霖, 陈媛, 骆艳. 贵州省托育机构医育结合服务现状及差异分析. 现代预防医学, 2026 , 53 (10) : 1866 -1872 . DOI: 10.20043/j.cnki.MPM.202512085
Yan-fang TANG, Yang HONG, Feng HONG, Qin-ying LONG, Tian-lin ZHANG, Yuan CHEN, Yan LUO. Analysis of the current status and variations in integrated medical and childcare services within infant care institutions,Guizhou[J]. Modern Preventive Medicine, 2026 , 53 (10) : 1866 -1872 . DOI: 10.20043/j.cnki.MPM.202512085
截止2024年底,我国出生人口为954万,人口出生率持续走低[1]。推动人口高质量发展是实现国家长远发展的战略部署。0-3岁婴幼儿照护服务是全生命周期健康管理的重要基础,对促进儿童早期发展、提升人口素质具有关键意义[2]。“医育结合”作为将医疗保健融入婴幼儿照护的创新模式,已成为婴幼儿照护服务体系建设的重点[3]。2023年,国家卫生健康委出台《关于促进医疗卫生机构支持托育服务发展的指导意见》[4],对各类医疗机构支持托育服务的内容进行了具体规范,以推动医育结合服务发展。北欧与日本等地的整合式照护与法定巡诊机制为我国提供了参考[5-7],我国也在医育结合实践方面进行了积极探索[8-10]。然而,现有研究多集中于政策与理论层面,针对中西部省份“医育结合”实践的系统性调查仍显不足。为此,本研究于2025年1月起对贵州省574家已备案托育机构展开调查,旨在了解其实施现状与困境,为区域政策优化与服务体系建设提供实证依据。
本研究采用普查方法,基于贵州省卫生健康委员会备案数据,以截至2024年12月31日全省643家已备案的托育机构为调查对象。排除已停业的25家机构后,初始纳入618家托育机构。经质量控制,最终574家机构完成完整调查,有效样本应答率为92.88%。纳入标准为:已实际收托婴幼儿并经卫生健康部门备案的托育机构(包括公办、民办、幼儿园托班、企事业单位办托等)。排除标准包括:未收托或未备案机构、不愿配合调查机构及已停业机构。本次研究已通过贵州护理职业技术学院伦理委员会审核通过(伦理号:gzhlllscb2024-1102)。
通过查阅文献资料,自行编制《贵州省托育机构医育结合照护服务现状调查问卷》,收集机构基本情况、保育照护、卫生保健及养育支持等资料。问卷经专家咨询后,结合预调查情况进行修改完善。
调查前开展预调查,并对调查人员进行统一培训。问卷回收后由各市州卫生健康部门指定1-2人进行复核,确保问卷的真实性和有效性。该问卷的Cronbach α系数为0.725,表明问卷具有良好的内部一致性信度。KMO值为0.760,Bartlett球形检验结果P<0.01,问卷结构效度良好。
采用SPSS 27.0软件对数据进行统计分析,分类变量以率和构成比(%)示,不同类型托育机构在保育照护、卫生保健、养育支持方面的差异性比较采用Fisher确切概率法进行分析。检验水准设置为α=0.05。
本次调查574家托育机构中,包括392家(68.29%)民办托育园,153家(26.66%)幼儿园托育班,24家(4.18%)公办托育园,5家(0.87%)企业配套托育。
据调查,在纳入调查的574家机构中,68.64%每日在园户外累计活动时间≥2小时,不同类型机构的差异显著(P<0.05)。在睡眠时是否有内巡视照护、睡眠用具是否定期消毒、食谱更换频率及是否根据婴幼儿身心发展特点制定活动计划和发展目标方面,不同托育机构均无显著差异(P>0.05)。详见表1。
(1)卫生保健制度建设情况
依据《托育机构质量评估标准》[11]托育机构卫生保健制度应包含一日生活制度(包含婴幼儿照护内容)、膳食管理制度、体格锻炼制度、卫生与消毒制度、健康检查制度、传染病预防与控制制度、常见疾病预防与管理制度、伤害预防制度、健康教育制度、卫生保健信息收集制度。据调查,有467家(81.36%)托育机构的卫生保健制度建设完整,不同类型机构的比较差异显著(P<0.05)。详见表2。
(2)卫生保健服务情况
调查显示,体格生长发育监测(80.14%)、口腔保健(79.44%)开展率较高,心理行为发育评估(51.74%)、眼保健服务(68.99%)次之,中医保健服务(13.07%)最低,机构间差异均显著(P<0.05)。建立个体健康管理档案(90.07%)与观看电子屏幕时间管理(95.30%)已较为普及,机构间均无显著差异(P>0.05)。意外伤害急救物资配备率仅为11.85%,机构间无显著差异(P>0.05)。详见表3。
在574家机构中,64.98%获得医疗照护指导,机构间差异不显著(P>0.05)。但其对满足婴幼儿保健需求的影响具有统计学意义(P<0.05)。详见表4。绝大多数机构(99.13%)提供家庭养育支持,94.60%希望深入解读《3岁以下婴幼儿健康养育照护指南(试行)》,机构间均无显著差异(P>0.05)。详见表5。
基于生态系统理论,托育机构作为婴幼儿发展的核心微系统,应整合医疗资源构建“健康微环境”,并加强与家庭、社区(系统)的互动。同时需关注政策与资源可及性(外系统)的间接影响,依托宏观政策突出关键期干预的重要性。结合公共卫生三级预防理论,可拓展托育机构功能,为理解“医育结合”机制提供整合性理论视角。
调查发现,每日在园户外累计活动时间≥2小时的托育机构仅有68.64%,机构间差异显著(P<0.05),提示户外活动照护总体质量不高且不同类型机构间在执行体格锻炼要求方面存在不平衡性。公办托育园(87.50%)与企事业单位配套托育(100%)执行率较高,民办园(62.50%)执行率偏低,反映民办托育园在场地、师资及成本等方面面临压力。睡眠用具消毒执行率普遍偏低,机构类型间无显著差异(P>0.05),提示各类机构均存在消毒不规范问题。睡眠巡视、食谱更换及活动计划制定等方面执行较好且无显著差异(P>0.05),表明托育行业在基础照护方面已形成一定规范,可能与近年来相关政策标准推动有关。
调查发现,仅81.36%的托育机构建立了完整的卫生保健制度,低于陈杰等(2023)对四川省的调查结果(100%)[12]。其中,公办机构制度建设完整率为100%,与四川省研究一致,可能与公办机构接受常态化政府监督有关;民办、幼儿园托班及企事业办园在此方面尚存不足。
调查发现,托育机构在卫生保健服务供给上呈现“基础规范统一、专业服务分化”的不均衡发展格局。在健康档案建立、电子屏幕时间管理等基础性、制度性环节,各类机构实施率普遍高于90%且组间无显著差异(P>0.05),反映出政策标准化要求已在行业形成基本管理共识,实现了服务底线的整体筑牢。
在体现专业深度与发展性照护的服务项目中,存在结构性差距。体格生长发育监测(80.14%)与口腔保健(79.44%)开展率较高,而心理行为发育评估(51.74%)与中医保健服务(13.07%)开展率较低,且机构间差异显著(P<0.05)。公办托育园表现全面,尤其在体格生长发育监测(100%)、眼与口腔保健(均为95.83%)及心理行为评估(70.83%)方面,体现其资源与政策执行优势。民办园作为供给主体,在心理行为评估(53.06%)与中医保健(14.29%)等领域存在明显短板,中医保健开展率较低这与全国研究一致[13],原因可能在于专业师资与成本压力。幼儿园托班口腔保健开展率较高(86.27%),得益于共享原有保健体系,但心理行为评估(47.06%)较弱,反映其偏重教育与日常照料,对专业评估融合不足。企事业单位配套托育在心理行为评估与中医保健方面缺位,表明其服务定位仍侧重于基本看护,发展性健康服务拓展动力不足。更为严峻的是,意外伤害急救物资的配备率低,仅为11.85%,且在不同类型机构中普遍存在(P>0.05),反映出大多数托育机构应急救护意识薄弱,应急救护准备严重欠缺,存在安全隐患。原因可能有三,一托育机构管理者认识不足,重养育,轻“医育”,未能将急救资源配置纳入服务安全的核心范畴;二运营成本高,急救物资既不能直接产生收益,使用频率又极低,机构缺乏主动配置的动力;三是因为卫生保健专业人员缺乏,专业能力的不足直接导致风险识别能力的缺失。
研究显示,医育结合推进中仍存在一定问题。64.98%的托育机构获得了医疗卫生机构的指导,机构间无显著差异(P>0.05),表明“医育”结合模式已初步呈现。然而,是否获得指导显著影响机构满足婴幼儿保健需求的能力(P<0.05),提示当前协作多停留于基础层面,指导内容、频率与专业性亟待加强,尚未形成系统化支持模式。94.60%的机构对医育结合政策存在深度解读需求,机构间无显著差异(P>0.05),反映政策在实践转化中仍面临普遍困难。同时,99.13%的机构已开展家庭养育支持服务,说明其已成为行业共识,但服务内容与质量是否契合家庭多样化需求,尚需进一步评估。
应强化标准建设与质量评估,提升照护服务质量。针对户外活动时长不足等问题,须严格落实每日≥2小时的户外活动要求,加强户外活动场地建设,加强安全监护与应急培训,增强其健康照护意识。同时需强化对睡眠用具消毒等环节的监督,推动托育服务规范化、法治化发展[14]。睡眠照护、食谱更换及发展目标制定等基础环节已具备较高规范性,表明现行标准体系有效。未来应推动服务从“标准化”向“优质化”升级,研制并推广精细化、年龄适配的实操工具包,如分月龄睡眠巡视表、标准化消毒流程、食谱分析工具及个性化发展目标模板等,将普遍规范转化为易执行的具体措施,从而加强质量监管,促进托育行业内涵式发展。
推进卫生保健制度的全面覆盖。当前全省仅81.36%的机构建设完整保健制度,应加强监督托育机构对政策制度的建设及执行情况,重点加强对民办、幼儿园托育班、企业办托育机构的制度建设的检查与指导,推动政策制度落地。
针对当前卫生保健服务“基础规范统一、专业服务分化”的困境,建议遵循“规范内容—做实服务—示范引领”的路径系统推进。首先,由省级部门牵头制定并动态更新《托育机构卫生保健服务实施细则》,明确生长发育监测、心理行为筛查、口腔与眼保健、中医保健等专业服务的具体内容、流程、人员资质及频次要求,为标准实施提供清晰指引。其次,通过财政补贴、政府购买服务等方式,支持机构引入专业人才,坚持“医育结合”[15],加强人员培训[16],可参考重庆“医-养-教结合”的职业院校合作模式[17]。依托区县级妇幼保健网络建立技术帮扶机制[18],定期开展入园指导与质量督导,推动文本标准转化为实际服务。结合本省中医药及苗族、侗族等民族医药资源,将苗医小儿推拿、侗医香囊防感配方、布依族药浴包等安全性高、易于操作的民族医药外治法运用于托育机构的中医保健,大力发展“中医药+托育服务”为特色的“医育结合”服务。最后,开展“医育结合”优秀机构评选,鼓励先进机构总结经验、开放观摩,发挥示范引领作用,带动行业整体突破专业能力瓶颈,实现服务从“保基本”向“优质量”跃升。
针对当前“医育结合”支持深度不足与政策转化困难,建议构建“1+4+N”整合服务模式。即一个省级信息化平台为支撑,贯通省、市、区(县)、乡(镇)四级联动网络,辐射覆盖机构卫生保健、“医育”人才培养、日常指导等N类应用场景。省级负责顶层设计,组建多学科专家委员会,制定统一规范;市级设立指导中心,协调资源并监督落实;区(县)依托妇幼保健机构建立培训指导中心,开展实操培训与督导;乡(镇)通过医共体组建基层支持团队,提供常态化入园指导与服务。其运行核心在于依托信息平台实现业务协同与数据共享,形成“省级指导、市级统筹、县级培训、乡级落地”的资源下沉体系。通过该模式将宏观政策系统转化为托育一线的常态化实践,全面提升“医育结合”服务效能。
本研究存在一定局限性。首先,采用横断面设计,虽能反映当前“医育结合”服务现状,但无法推断变量间的因果关系。其次,样本仅包含已备案托育机构,未涵盖未备案机构及家庭托育点,结果未能完全代表贵州省托育服务的整体情况。
  • 贵州省卫生健康委科学技术基金项目(gzwkj2022-199)
  • 贵州护理职业技术学院院级课题(gzhlyj2024-03)
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2026年第53卷第10期
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doi: 10.20043/j.cnki.MPM.202512085
  • 接收时间:2025-12-04
  • 首发时间:2026-11-02
  • 出版时间:2026-05-25
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  • 收稿日期:2025-12-04
基金
贵州省卫生健康委科学技术基金项目(gzwkj2022-199)
贵州护理职业技术学院院级课题(gzhlyj2024-03)
作者信息
    1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
    2.贵州护理职业技术学院
    3.贵阳市妇幼保健院儿童保健科

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
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