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Article(id=1324078001557742085, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508216, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755187200000, receivedDateStr=2025-08-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614395751, onlineDateStr=2026-11-02, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614395751, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614395751, creator=13701087609, updateTime=1793614395751, updator=13701087609, issue=Issue{id=1324077868950631142, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614364134, creator='13701087609', updateTime=1793614446224, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078213328142371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078213332336676, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=657, endPage=661, ext={EN=ArticleExt(id=1324078001897480710, articleId=1324078001557742085, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Assessing the integration of healthcare and childcare, Hunan, China: Institutional supply and demand characteristics, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the integration of healthcare and childcare status in Hunan, China, and toexplore its institutional demand characteristics to promote further integration of healthcare and childcare.

Methods

A questionnaire survey was conducted at 257 healthcare institutions and 365 childcare institutions in Hunan, China were investigated in Jun-Sep, 2024. Univariate and multiple response analyses were performed on the data.

Results

A total of 82 healthcare institutions (31.9%) and 244 childcare institutions (66.8%) achieved healthcare and childcare integration. Maternal and child health care institutions served significantly more childcare institutions on average compared to other types of medical institutions(χ2=7.897, P=0.001).The satisfaction level of parents with childcare institutions adopting healthcare and childcare integration was higher than that of institutions that did not adopt integration (81.6% vs.70.2%, χ2=5.992, P=0.014). Among the services provided by healthcare institutions, practitioner training had lowest response rate (16.2%) and popularity rate (63.4%), but childcare institutions showed the maximum demand for it (response rate=24.3%, popularity rate=93.7%).

Conclusion

Maternity and child care institutions have enhanced healthcare and childcare integration, effectively improving parent satisfaction. The services provided by healthcare institutions are not consistent with the practical demand by childcare institutions.

, authors=Wei-na ZHANG1, Pin FENG2, Nan ZHOU3, Bin-bin FENG1, Liang ZHOU4, Xing-Lei WANG1, Hui-xia LI1, Jun-qun FANG1, authorsList=Wei-na ZHANG, Pin FENG, Nan ZHOU, Bin-bin FENG, Liang ZHOU, Xing-Lei WANG, Hui-xia LI, Jun-qun FANG, authorCompany=null, correspAuthors=Jun-qun FANG, 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=1324078002702787081, articleId=1324078001557742085, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=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, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的

了解湖南省医育结合服务的发展现状及托育机构实际需求，为推进医育结合工作提供依据。

方法

于2024年6—9月，在湖南省随机抽取257家医疗机构和365所托育机构开展问卷调查。运用单因素分析和多重响应分析方法进行分析。

结果

82家医疗机构（31.9%）和244所托育机构（66.8%）开展医育结合服务；妇幼保健机构平均服务的托育机构数量明显高于其他类型的医疗机构（χ2=7.897，P=0.001）；家长对开展医育结合服务的托育机构满意度更高（81.6% vs.70.2%，χ2=5.992，P=0.014）；医疗机构提供的服务类型中，从业人员培训的响应率（16.2%）和普及率（63.4%）最低，而托育机构对其需求最高（响应率24.3%，普及率93.7%）。

结论

妇幼保健机构在医育结合工作中有明显优势，开展医育结合服务能够提升家长的满意度，医疗机构所提供的服务与托育机构的实际需求不一致。

, authors=张唯娜1, 冯频2, 周南3, 冯彬彬1, 周亮4, 汪星磊1, 李辉霞1, 方俊群1, authorsList=张唯娜, 冯频, 周南, 冯彬彬, 周亮, 汪星磊, 李辉霞, 方俊群, authorCompany=null, correspAuthors=方俊群, authorNote=

张唯娜（1994—），女，硕士，主治医师，研究方向：婴幼儿照护

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方俊群，E-mail:
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张唯娜（1994—），女，硕士，主治医师，研究方向：婴幼儿照护

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张唯娜（1994—），女，硕士，主治医师，研究方向：婴幼儿照护

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National statistical survey system for childcare services[EB/OL]. [2026-01-06]. https://www.stats.gov.cn/fw/bmdcxmsp/bmzd/202302/t20230215_1907228. (In Chinese), articleTitle=National statistical survey system for childcare services, refAbstract=null), Reference(id=1324078012651676265, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=6, pageStart=1037, pageEnd=1043, url=null, language=null, rfNumber=[16], rfOrder=28, authorNames=李硕林, 崔汉辰, 陈振南, journalName=现代预防医学, refType=null, unstructuredReference=李硕林，崔汉辰，陈振南，等．海南省大学生代餐食品知信行调查分析[J]．现代预防医学，2025，52（6）：1037-1043．, articleTitle=海南省大学生代餐食品知信行调查分析, refAbstract=null), Reference(id=1324078012727173738, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=6, pageStart=1037, pageEnd=1043, url=null, language=null, rfNumber=[16], rfOrder=29, authorNames=Li SL, Cui HC, Chen ZN, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Li SL, Cui HC, Chen ZN, et al. Investigation on knowledge-attitude-practices(KAP)of meal replacement food among college students in Hainan Province[J]. Modern Preventive Medicine, 2025, 52(6): 1037-1043. 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(In Chinese), articleTitle=The promotion and application of the high-quality “healthcare and childcare integration” childcare service model in childcare services, refAbstract=null), Reference(id=1324078014555890285, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, doi=null, pmid=null, pmcid=null, year=2024, volume=15, issue=4, pageStart=55, pageEnd=60, url=null, language=null, rfNumber=[18], rfOrder=32, authorNames=陈杰, 刘绪义, 宋文健, journalName=中国妇幼卫生杂志, refType=null, unstructuredReference=陈杰，刘绪义，宋文健，等．四川省眉山市29家托育机构服务能力的现状调查[J]．中国妇幼卫生杂志，2024，15（4）：55-60．, articleTitle=四川省眉山市29家托育机构服务能力的现状调查, refAbstract=null), Reference(id=1324078014673330798, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, doi=null, pmid=null, pmcid=null, year=2024, volume=15, issue=4, pageStart=55, pageEnd=60, url=null, language=null, rfNumber=[18], rfOrder=33, authorNames=Chen J, Liu XY, Song WJ, journalName=Chinese Journal of Women and Children Health, refType=null, unstructuredReference=Chen J, Liu XY, Song WJ, et al. Research on the current situation of infant care service capability of 29 nursery institution in Meishan, Sichuan Province[J]. Chinese Journal of Women and Children Health, 2024, 15(4): 55-60. (In Chinese), articleTitle=Research on the current situation of infant care service capability of 29 nursery institution in Meishan, Sichuan Province, refAbstract=null)], funds=[Fund(id=1324078008457372235, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, awardId=24BRK022, language=CN, fundingSource=国家社会科学基金(24BRK022), fundOrder=null, country=null), Fund(id=1324078010130899532, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, awardId=2023RX19, language=CN, fundingSource=湖南省妇幼保健院(2023RX19), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078002920890890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, xref=1., ext=[AuthorCompanyExt(id=1324078002929279499, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, companyId=1324078002920890890, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Center of Hunan Infant Care Service Guidance, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan 410005, China), AuthorCompanyExt(id=1324078002937668108, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, companyId=1324078002920890890, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.湖南省妇幼保健院，湖南省婴幼儿照护服务指导中心，湖南 长沙 410005)]), AuthorCompany(id=1324078003013165581, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, xref=2., ext=[AuthorCompanyExt(id=1324078003021554190, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, companyId=1324078003013165581, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.南华大学公共卫生学院)]), AuthorCompany(id=1324078003080274447, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, xref=3., ext=[AuthorCompanyExt(id=1324078003088663056, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, companyId=1324078003080274447, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.湖南省卫生健康委人口监测与家庭发展处)]), AuthorCompany(id=1324078003147383313, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, xref=4., ext=[AuthorCompanyExt(id=1324078003155771922, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, companyId=1324078003147383313, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.长沙师范学院，学前教育学院)])], figs=[ArticleFig(id=1324078007576568385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=EN, label=Table 1, caption=

Integration of healthcare and childcare across different healthcare institutions (n=82)

, figureFileSmall=null, figureFileBig=null, tableContent=
条目医疗机构类型[n（%）]总计
（n=82)		χ2/FP
社区卫生服务中心
（n=45）		妇幼保健机构
（n=29）		其他医疗卫生机构
（n=8）
服务的托育机构数量（家）4.00±4.747.79±4.632.37±2.075.18±4.907.8970.001
开展医育结合服务是否向托育机构收费0.4590.795
是7(15.6)6(20.7)1(12.5)14(17.1)
否38(84.4)23(79.3)7(87.5)68(82.9)
年服务人次（人次）614.82±1 203.722 404.14±5 829.48843.50±1 097.161 269.94±3 654.482.2410.113
服务频次（次/月）3.24±1.033.41±0.953.88±0.353.37±0.961.5330.222
), ArticleFig(id=1324078007660454466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=CN, label=表1, caption=

不同医疗机构医育结合服务开展情况比较（n=82）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目医疗机构类型[n（%）]总计
（n=82)		χ2/FP
社区卫生服务中心
（n=45）		妇幼保健机构
（n=29）		其他医疗卫生机构
（n=8）
服务的托育机构数量（家）4.00±4.747.79±4.632.37±2.075.18±4.907.8970.001
开展医育结合服务是否向托育机构收费0.4590.795
是7(15.6)6(20.7)1(12.5)14(17.1)
否38(84.4)23(79.3)7(87.5)68(82.9)
年服务人次（人次）614.82±1 203.722 404.14±5 829.48843.50±1 097.161 269.94±3 654.482.2410.113
服务频次（次/月）3.24±1.033.41±0.953.88±0.353.37±0.961.5330.222
), ArticleFig(id=1324078007735951939, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=EN, label=Table 2, caption=

Reasons and intention of healthcare institutions that do not provide healthcare and childcare integration (n=175)

, figureFileSmall=null, figureFileBig=null, tableContent=
条目医疗机构类型[n（%）]总计
（n=175）		χ2P
社区卫生服务中心
（n=124）		妇幼保健机构
（n=24）		其他医疗机构
（n=27）
未开展医育结合服务的原因8.9880.343
不了解相关政策29(23.4)4(16.7)8(29.6)41(23.4)
无配套经费/人员支持68(54.8)19(79.2)14(51.9)101(57.7)
不能提供所需服务13(10.5)1(4.1)1(3.7)15(8.7)
与托育机构缺乏联系12(9.7)0(0.0)4(14.8)16(9.1)
医务人员缺乏积极性2(1.6)0(0.0)0(0.0)2(1.1)
服务意愿11.2310.004
愿意64(51.6)20(83.3)20(74.1)104(59.4)
不愿意60(48.4)4(16.7)7(25.9)71(40.6)
), ArticleFig(id=1324078007824032324, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=CN, label=表2, caption=

不同医疗机构未开展医育结合服务的原因及意愿分析（n=175）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目医疗机构类型[n（%）]总计
（n=175）		χ2P
社区卫生服务中心
（n=124）		妇幼保健机构
（n=24）		其他医疗机构
（n=27）
未开展医育结合服务的原因8.9880.343
不了解相关政策29(23.4)4(16.7)8(29.6)41(23.4)
无配套经费/人员支持68(54.8)19(79.2)14(51.9)101(57.7)
不能提供所需服务13(10.5)1(4.1)1(3.7)15(8.7)
与托育机构缺乏联系12(9.7)0(0.0)4(14.8)16(9.1)
医务人员缺乏积极性2(1.6)0(0.0)0(0.0)2(1.1)
服务意愿11.2310.004
愿意64(51.6)20(83.3)20(74.1)104(59.4)
不愿意60(48.4)4(16.7)7(25.9)71(40.6)
), ArticleFig(id=1324078007924695621, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=EN, label=Table 3, caption=

Univariate analysis on integration of healthcare and childcare across different childcare institutions (n=365)

, figureFileSmall=null, figureFileBig=null, tableContent=
条目托育机构开展医育结合服务总计（n=365）χ2/tP
是（n=244）否（n=121）
地区分类（按2024年人均GDP水平）6.9470.031
≥10万元78(32.0)50(41.3)128(35.1)
≥5万元且<10万元116(47.5)40(33.1)156(42.7)
<5万元50(20.5)31(25.6)81(22.2)
机构分类0.8790.644
托育机构151(61.9)70(57.9)221(60.6)
幼儿园托班83(34.0)47(38.8)130(35.6)
其他10(4.1)4(3.3)14(3.8)
机构类型0.9540.812
公办29(11.9)16(13.2)45(12.3)
公建民营3(1.2)3(2.5)6(1.6)
民办197(80.7)95(78.5)292(80.0)
民办公助15(6.2)7(5.8)22(6.1)
托位数（个）91.48±40.5584.76±35.6189.25±39.06-1.5500.122
入托人数（人）55.65±43.8254.21±38.0855.17±41.96-0.3080.758
机构备案情况0.0270.869
是233(95.5)116(95.9)349(95.6)
否11(4.5)5(4.1)16(4.4)
乳儿班（0~1岁）开设情况1.4080.235
开设19(7.8)14(11.6)33(9.0)
未开设225(92.2)107(88.4)332(91.0)
家长对托育机构服务是否满意5.9920.014
满意199(81.6)85(70.2)284(77.8)
不满意45(18.4)36(29.8)81(22.2)
从业人员获取医疗知识的途径46.332<0.001
网络74(30.3)82(67.8)156(42.7)
向医务人员咨询170(69.7)39(32.2)209(57.3)
), ArticleFig(id=1324078008008581702, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=CN, label=表3, caption=

托育机构医育结合服务开展情况单因素分析（n=365）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目托育机构开展医育结合服务总计（n=365）χ2/tP
是（n=244）否（n=121）
地区分类（按2024年人均GDP水平）6.9470.031
≥10万元78(32.0)50(41.3)128(35.1)
≥5万元且<10万元116(47.5)40(33.1)156(42.7)
<5万元50(20.5)31(25.6)81(22.2)
机构分类0.8790.644
托育机构151(61.9)70(57.9)221(60.6)
幼儿园托班83(34.0)47(38.8)130(35.6)
其他10(4.1)4(3.3)14(3.8)
机构类型0.9540.812
公办29(11.9)16(13.2)45(12.3)
公建民营3(1.2)3(2.5)6(1.6)
民办197(80.7)95(78.5)292(80.0)
民办公助15(6.2)7(5.8)22(6.1)
托位数（个）91.48±40.5584.76±35.6189.25±39.06-1.5500.122
入托人数（人）55.65±43.8254.21±38.0855.17±41.96-0.3080.758
机构备案情况0.0270.869
是233(95.5)116(95.9)349(95.6)
否11(4.5)5(4.1)16(4.4)
乳儿班（0~1岁）开设情况1.4080.235
开设19(7.8)14(11.6)33(9.0)
未开设225(92.2)107(88.4)332(91.0)
家长对托育机构服务是否满意5.9920.014
满意199(81.6)85(70.2)284(77.8)
不满意45(18.4)36(29.8)81(22.2)
从业人员获取医疗知识的途径46.332<0.001
网络74(30.3)82(67.8)156(42.7)
向医务人员咨询170(69.7)39(32.2)209(57.3)
), ArticleFig(id=1324078008105050695, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=EN, label=Table 4, caption=

Mode, type and content of healthcare and childcare integration in different institutions (n=82)

, figureFileSmall=null, figureFileBig=null, tableContent=
条目响应普及率
（%）		χ2P
n响应率
（%）
服务模式20.110<0.001
签订合作协议5932.572.0
设立照护门诊5731.369.5
开设育儿学校4524.754.9
医务人员巡回派驻2111.525.6
服务类型10.5080.032
科普宣教8024.897.6
现场健康服务7723.993.9
从业人员培训5216.263.4
中医保健服务5617.468.3
绿色通道转诊5717.769.5
服务内容8.7200.121
营养喂养7618.092.7
伤害预防及急救8019.097.6
传染病及常见病防控8019.097.6
日常护理6916.484.1
心理卫生保健与回应性照护6615.580.5
早期学习机会5112.162.2
), ArticleFig(id=1324078008180548168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=CN, label=表4, caption=

医疗机构开展医育结合的服务模式、类型及内容（n=82）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目响应普及率
（%）		χ2P
n响应率
（%）
服务模式20.110<0.001
签订合作协议5932.572.0
设立照护门诊5731.369.5
开设育儿学校4524.754.9
医务人员巡回派驻2111.525.6
服务类型10.5080.032
科普宣教8024.897.6
现场健康服务7723.993.9
从业人员培训5216.263.4
中医保健服务5617.468.3
绿色通道转诊5717.769.5
服务内容8.7200.121
营养喂养7618.092.7
伤害预防及急救8019.097.6
传染病及常见病防控8019.097.6
日常护理6916.484.1
心理卫生保健与回应性照护6615.580.5
早期学习机会5112.162.2
), ArticleFig(id=1324078008260239945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=EN, label=Table 5, caption=

Demand for healthcare and childcare integration in different childcare institutions (n=365)

, figureFileSmall=null, figureFileBig=null, tableContent=
条目响应普及率
（%）		χ2P
n响应率
（%）
服务类型77.525< 0.001
科普宣教33723.992.3
现场健康服务32222.888.2
从业人员培训34224.393.7
中医保健服务23316.563.8
绿色通道转诊17612.548.2
服务内容22.687< 0.001
营养喂养28015.076.7
伤害预防及急救35218.996.4
传染病及常见病防控34818.795.3
日常护理31216.885.5
心理卫生保健与回应性照护31316.885.8
早期学习机会25613.870.1
), ArticleFig(id=1324078008344126026, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078001557742085, language=CN, label=表5, caption=

托育机构对医育结合服务的需求（n=365）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目响应普及率
（%）		χ2P
n响应率
（%）
服务类型77.525< 0.001
科普宣教33723.992.3
现场健康服务32222.888.2
从业人员培训34224.393.7
中医保健服务23316.563.8
绿色通道转诊17612.548.2
服务内容22.687< 0.001
营养喂养28015.076.7
伤害预防及急救35218.996.4
传染病及常见病防控34818.795.3
日常护理31216.885.5
心理卫生保健与回应性照护31316.885.8
早期学习机会25613.870.1
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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
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张唯娜 1 , 冯频 2 , 周南 3 , 冯彬彬 1 , 周亮 4 , 汪星磊 1 , 李辉霞 1 , 方俊群 1
现代预防医学 | 卫生政策与管理 2026,53(4): 657-661
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现代预防医学 |卫生政策与管理 2026 , 53 (4) : 657 -661
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
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张唯娜1, 冯频2, 周南3, 冯彬彬1, 周亮4, 汪星磊1, 李辉霞1, 方俊群1
作者信息
  • 1.湖南省妇幼保健院，湖南省婴幼儿照护服务指导中心，湖南 长沙 410005
  • 2.南华大学公共卫生学院
  • 3.湖南省卫生健康委人口监测与家庭发展处
  • 4.长沙师范学院，学前教育学院
通讯作者:
方俊群，E-mail:
作者简介:

张唯娜（1994—），女，硕士，主治医师，研究方向：婴幼儿照护

Assessing the integration of healthcare and childcare, Hunan, China: Institutional supply and demand characteristics
Wei-na ZHANG1, Pin FENG2, Nan ZHOU3, Bin-bin FENG1, Liang ZHOU4, Xing-Lei WANG1, Hui-xia LI1, Jun-qun FANG1
Affiliations
  • Center of Hunan Infant Care Service Guidance, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan 410005, China
出版时间: 2026-02-25 doi: 10.20043/j.cnki.MPM.202508216
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摘要
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目的

了解湖南省医育结合服务的发展现状及托育机构实际需求，为推进医育结合工作提供依据。

方法

于2024年6—9月，在湖南省随机抽取257家医疗机构和365所托育机构开展问卷调查。运用单因素分析和多重响应分析方法进行分析。

结果

82家医疗机构（31.9%）和244所托育机构（66.8%）开展医育结合服务；妇幼保健机构平均服务的托育机构数量明显高于其他类型的医疗机构（χ2=7.897，P=0.001）；家长对开展医育结合服务的托育机构满意度更高（81.6% vs.70.2%，χ2=5.992，P=0.014）；医疗机构提供的服务类型中，从业人员培训的响应率（16.2%）和普及率（63.4%）最低，而托育机构对其需求最高（响应率24.3%，普及率93.7%）。

结论

妇幼保健机构在医育结合工作中有明显优势，开展医育结合服务能够提升家长的满意度，医疗机构所提供的服务与托育机构的实际需求不一致。

医育结合  /  托育机构  /  需求
Objective

To investigate the integration of healthcare and childcare status in Hunan, China, and toexplore its institutional demand characteristics to promote further integration of healthcare and childcare.

Methods

A questionnaire survey was conducted at 257 healthcare institutions and 365 childcare institutions in Hunan, China were investigated in Jun-Sep, 2024. Univariate and multiple response analyses were performed on the data.

Results

A total of 82 healthcare institutions (31.9%) and 244 childcare institutions (66.8%) achieved healthcare and childcare integration. Maternal and child health care institutions served significantly more childcare institutions on average compared to other types of medical institutions(χ2=7.897, P=0.001).The satisfaction level of parents with childcare institutions adopting healthcare and childcare integration was higher than that of institutions that did not adopt integration (81.6% vs.70.2%, χ2=5.992, P=0.014). Among the services provided by healthcare institutions, practitioner training had lowest response rate (16.2%) and popularity rate (63.4%), but childcare institutions showed the maximum demand for it (response rate=24.3%, popularity rate=93.7%).

Conclusion

Maternity and child care institutions have enhanced healthcare and childcare integration, effectively improving parent satisfaction. The services provided by healthcare institutions are not consistent with the practical demand by childcare institutions.

Integration of healthcare and childcare  /  Childcare institutions  /  Demand
张唯娜, 冯频, 周南, 冯彬彬, 周亮, 汪星磊, 李辉霞, 方俊群. 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. 现代预防医学, 2026 , 53 (4) : 657 -661 . DOI: 10.20043/j.cnki.MPM.202508216
Wei-na ZHANG, Pin FENG, Nan ZHOU, Bin-bin FENG, Liang ZHOU, Xing-Lei WANG, Hui-xia LI, Jun-qun FANG. Assessing the integration of healthcare and childcare, Hunan, China: Institutional supply and demand characteristics[J]. Modern Preventive Medicine, 2026 , 53 (4) : 657 -661 . DOI: 10.20043/j.cnki.MPM.202508216
正文
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托育服务作为0~3岁婴幼儿照护的重要形式，其健康服务属性日益受到重视[1-2]。医育结合是指将医疗与托育资源进行整合，通过为托育机构提供医疗保健服务和指导，为婴幼儿提供照护支持[3]。为推进医育结合工作，国家卫生健康委已出台文件[4]，对各类医疗机构支持托育服务的内容进行了具体规范，包括开展订单签约、加强照护指导、发挥中医药特色等。
国际上普遍重视医疗服务对托育的支持作用，如法国医务人员定期监测托育机构婴幼儿的营养状况和发育水平，实现对常见病的早期干预[5]；美国派遣护士进入日托中心，与医疗机构建立转诊通道协调早期干预服务[6]。近年来，国内多地已开展实践探索，如海南省三亚市[7]推动基层医疗卫生机构与托育机构合作，北京市[8]派驻医务人员定期赴托育机构提供服务，四川省探索多学科巡园模式对托育机构进行医育结合管理指导[9]，广州市、上海市[10]则依托社区卫生中心开展早期发展示范点工作等。现有研究表明，已有超过60.0%的托育机构在尝试开展医育结合服务[11]，医育结合对婴幼儿的身心发展有积极作用[12-13]。然而，我国医育结合工作处于起步阶段，现有研究多仅关注对实践路径的探讨，缺乏对医疗机构供给现状以及托育机构需求等关键问题的研究[14]。
本文将提供医疗服务的医疗机构视为“供给端”，将接受医疗服务的托育机构视为“需求端”，进行现况调查，旨在了解湖南省医育结合服务的发展现状及托育机构的实际需求，为推进医育结合工作提供参考依据。
1　资料与方法
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1.1　调查对象
本研究数据来源于湖南省婴幼儿照护服务指导中心《医疗卫生机构支持托育服务发展专项调查》项目（审查批准号：2023-S073）。于2024年6—9月在湖南省14个市州中各随机抽取20家医疗机构、30家托育机构参与问卷调查。共发放医疗机构问卷280份，回收有效问卷257份，应答率为91.8%；发放托育机构问卷420份，回收有效问卷365份，应答率为86.9%。
纳入标准：①医疗机构：包括社区卫生服务中心、妇幼保健机构、其他医疗机构（含中医医院、综合医院、儿童专科医院等）。②托育机构：为3岁以下婴幼儿提供照护服务的托育机构，包括托育机构、幼儿园托班、家庭托育点等。
1.2　调查方法及内容
使用问卷星进行在线问卷调查。问卷参考《全国托育服务统计调查制度》[15]制定，并经2轮德尔菲专家咨询法修订完善，共邀请来自公共卫生、妇幼保健、托育管理领域的15名专家参与评议，专家权威程度平均值0.8，两轮咨询的意见一致性Kendall协调系数W值分别为0.61（P<0.001）和0.72（P<0.001）。由于部分题项为多选题，未进行内部一致性信度检验。医疗机构问卷内容包括：机构类型、医育结合服务模式、服务类型及内容、开展意愿等。托育机构问卷内容包括：机构类型、托位数、家长满意度、服务需求等。
1.3　质量控制
本次调查以工作通知对机构负责人进行指导，数据收集后进行清洗，对不符合要求的数据进行剔除。
1.4　统计分析方法
使用SPSS 26.0进行统计分析，计数资料采用n（%）描述，组间比较采用卡方检验；计量资料数据以（）描述，组间比较采用t检验或F检验。对于多选题，使用多重响应分析方法[16]，采用响应率（指选择某选项的人数在总选择次数中的比例，用于比较不同选项之间的受欢迎程度或选择频率，各选项的响应率之和为100%）和普及率（指选择某选项人数占总人数的百分比，用于评估该选项在调查中的普及程度或覆盖范围）两个指标来进行描述，利用卡方拟合优度检验验证各选项间是否有差异。检验水准α=0.05（双侧）。
2　研究结果
收起
2.1　基本情况
257家医疗机构中，包括169家（65.8%）社区卫生服务中心，53家（20.6%）妇幼保健机构，3家（1.2%）儿童专科医院，18家（7.0%）综合医院，14家（5.4%）中医医院。365所托育机构则包括纯托育机构221所（60.6%）、幼儿园托班130所（35.6%）和其他类型（家庭托育点、社区托育点）14所（3.8%）。
2.2　医育结合服务开展情况
2.2.1　供给方：医疗机构的服务开展情况
共有82家医疗机构提供医育结合服务。妇幼保健机构服务的托育机构数量（7.79±4.63）（所）明显高于其余两类（χ2=7.897，P=0.001）（表1）。175家医疗机构未开展医育结合服务的原因主要为无配套经费和人员支持（57.7%）。此外，妇幼保健机构开展医育结合服务的意愿（83.3%）明显高于其他类型的医疗机构（χ2=11.231，P=0.004）（表2）。
2.2.2　需求方：托育机构的服务采纳与效果
调查的365所托育机构中，共有244所（66.8%）托育机构接受了医育结合服务。开展医育结合服务的托育机构主要来自中、高经济水平地区（χ2=6.947，P=0.031）。此外，开展医育结合服务的托育机构其家长满意度（81.6%）高于未开展的托育机构（70.2%）（χ2=5.992，P=0.014）。表3显示，已开展医育结合服务的托育机构，其从业人员主要通过向医务人员咨询（69.7%）来获取医疗知识，而未开展的托育机构其从业人员则主要通过网络（67.8%）途径获取（χ2=46.332，P<0.001）。
2.3　医育结合服务供需匹配情况
2.3.1　医疗机构服务供给情况
采用多重响应分析对82家提供医育结合服务的医疗机构供给情况进行调查。表4显示，在服务模式选择上，签订合作协议的响应率（32.5%）和普及率（72.0%）最高，而医务人员巡回派驻的响应率（11.5%）和普及率（25.6%）最低，不同服务模式的选择分布存在显著性差异（χ2=20.110，P<0.001）。在服务类型上，科普宣教的响应率（24.8%）和普及率（97.6%）最高，从业人员培训的响应率（16.2%）和普及率（63.4%）最低，不同服务类型的选择分布存在显著性差异（χ2=10.508，P=0.032）。
2.3.2　托育机构服务需求情况
采用多重响应分析对365家托育机构的服务需求进行调查，结果显示：托育机构对从业人员培训的响应率（24.3%）和普及率（93.7%）最高，对绿色通道转诊服务响应率（12.5%）和普及率（48.2%）最低，各服务类型的需求分布存在显著性差异（χ2=77.525，P<0.001）。在医育结合的服务内容方面，托育机构对“伤害预防及急救”“传染病及常见病防控”“心理卫生保健与回应性照护”以及“婴幼儿日常护理”这四项内容的响应率和普及率较高。
3　讨论
收起
3.1　医育结合正由“试点探索”向“规模化实践”过渡，区域差异仍存
湖南省66.8%的托育机构已开展医育结合服务，与前期研究一致[11]，反映出托育机构对医疗服务的刚性需求。然而，其发展并非均衡，开展医育结合服务的托育机构主要来自中、高经济水平地区，且“没有配套经费和人员支持”是医疗机构未开展服务的首要因素，因缺乏财政投入和考核激励机制，医疗机构积极性不足。建议相关部门予以专项经费支持，出台激励措施，对派驻医务人员在托育机构服务工作符合条件的，视作基层服务时间，加速医育结合服务发展。
3.2　妇幼保健机构的核心引领作用
在各类医疗机构中，妇幼保健机构展现出显著优势：其服务的托育机构数量（7.79±4.63）（所）远高于其他类型的医疗机构，且开展的意愿最为强烈（83.3%）。这可能得益于湖南省依托其成立指导中心的政策导向，使其成为医育结合的核心执行者。相比之下，受运营模式等因素的制约，其他类型的医疗机构在服务开展中未表现出明显优势。未来应结合不同医疗机构的特点，如依托妇幼保健院建立区域指导中心，鼓励基层医疗机构开展订单签约服务，发挥中医药特色，推广小儿推拿、穴位贴敷等，差异化推进医育结合工作。
3.3　服务模式偏好及现实约束
在具体实施层面，医方主导服务模式为签约合作及设立门诊，与前期研究结论相符[11]，而“医务人员巡回派驻”的响应率和普及率最低，这本质上是医疗机构基于现有资源的一种理性选择。签约模式能够通过协议，为托育机构提供长期集中的医疗服务；门诊模式则可依托现有诊室改造，降低了服务成本。而巡回派驻需要协调医务人员脱产入驻，往往与其本职工作存在时间冲突，难以有效开展。
3.4　医育结合能提升家长满意度与服务质量
尽管面临诸多现实约束，医育结合已显现出积极的服务效果。首先，开展医育结合服务能提升婴幼儿家长的满意度。与未开展医育结合服务的托育机构相比，家长对提供医育结合服务的托育机构满意度更高。滕艳云等[17]的研究亦证实，医育结合服务有利于婴幼儿的早期发展，提升家长信任度。这表明，医育结合有效提升了家长对托育机构专业性和安全性的信任。鉴于当前家长对托育机构普遍存在顾虑[18]的现状，通过推行医育结合来增强其对托育的满意度，是一种可行的路径。其次，医育结合服务能改变托育机构从业人员获取医疗卫生知识的途径。开展医育结合服务的托育机构从业人员主要通过咨询医务人员来获取相关知识，而未开展服务的机构则高度依赖网络，其知识的准确性和权威性难以保证。这一转变不仅提升了照护人员的专业素养，也为托育服务的规范化运行提供了有力保障。
3.5　供需结构性错配亟待破解
本研究重要的发现之一是医疗机构所提供的服务与托育机构的实际需求存在不一致。在服务类型中，医疗机构从业人员培训供给最低，而托育机构对其需求最高，揭示了目前对托育机构从业人员的培训存在明显短缺。目前托育机构从业人员普遍学历较低，且婴幼儿相对集中，开展相关培训非常有必要。建议针对伤害预防及传染病防控等托育机构最需要的内容开展培训，提升培训覆盖率与质量。
本研究从供需视角出发，系统揭示了湖南省医育结合服务的开展现状、开展效果及供需特征。然而，横断面调查在解释开展效果的因果关系上存在局限性。未来应开展纵向研究，分析医育结合服务对婴幼儿早期发展结局的影响。此外，可采用质性研究的方法开展访谈调查，探讨医育结合工作中面临的挑战及相关建议，与量化研究结果形成互补，为精准施策提供更全面的依据。
基金
收起
  • 国家社会科学基金(24BRK022)
  • 湖南省妇幼保健院(2023RX19)
文献
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2026年第53卷第4期
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doi: 10.20043/j.cnki.MPM.202508216
  • 接收时间：2025-08-15
  • 首发时间：2026-11-02
  • 出版时间：2026-02-25
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  • 收稿日期：2025-08-15
基金
国家社会科学基金(24BRK022)
湖南省妇幼保健院(2023RX19)
作者信息
    1.湖南省妇幼保健院，湖南省婴幼儿照护服务指导中心，湖南 长沙 410005
    2.南华大学公共卫生学院
    3.湖南省卫生健康委人口监测与家庭发展处
    4.长沙师范学院，学前教育学院

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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Percentage of total
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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
栓菌属 Trametes 5 2.39
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