Cox S, Mpofu F, Berg A, Rode H
Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa.
S Afr Med J. 2006 Sep;96(9 Pt 2):945-9.
The objective was to evaluate the role of a paediatric surgical consultant at a primary health care facility.
Descriptive and prospective.
In the process of planning and implementation of the 2010 health plan of the Provincial Government of the Western Cape, a shift occurred in the delivery of health care to children from a provincially based hospital system to a municipally based primary health care system. To contribute towards enabling this process, the Department of Paediatric Surgery at Red Cross War Memorial Children's Hospital established a paediatric surgical day clinic at a local community health centre during 2001.
Information was obtained from patient data sheets containing details of consultations at the sub-specialist surgical clinic at Michael Mapongwana Community Health Centre.
Over a 58-month period 1 171 children were seen, of whom 655 were male and 427 female. Their ages ranged from 0 to 19 years, the largest group being under 1 year. Eighty per cent of patients were accompanied by their mothers. The correct diagnosis was established by the nurse practitioners in 71%. General paediatric surgical conditions predominated, followed by medical, dermatological, orthopaedic, trauma, otolaryngo-pharyngology, infectious diseases, ophthalmology, urology, neurosurgery, malignancy and maxillofacial conditions. The details are set out in the report. In total 597 patients were referred directly to an appropriate care facility and 574 patients could be managed entirely at the clinic level.
This study demonstrated the significant public health problem of paediatric surgical disease. It emphasized the preventative and cost-effective role of a surgical clinic at primary health care level. The clinic allowed for timely surgical intervention in 65% of surgical cases, thereby decreasing inappropriate tertiary referrals. We believe that bringing specialists into the community can only strengthen the 2010 health care plan.
评估儿科外科顾问在基层医疗保健机构中的作用。
描述性和前瞻性研究。
在西开普省政府2010年卫生计划的规划和实施过程中，儿童医疗保健的提供从省级医院系统转向了市级基层医疗保健系统。为推动这一进程，红十字会战争纪念儿童医院的儿科外科于2001年在当地社区卫生中心设立了儿科外科日间诊所。
从包含迈克尔·马蓬瓦纳社区卫生中心专科外科诊所会诊详细信息的患者数据表中获取信息。
在58个月的时间里，共诊治了1171名儿童，其中男性655名，女性427名。年龄范围为0至19岁，最大的群体为1岁以下。80%的患者由母亲陪同。执业护士做出正确诊断的比例为71%。小儿普通外科疾病占主导，其次是内科、皮肤科、骨科、创伤、耳鼻喉科、传染病、眼科、泌尿外科、神经外科、恶性肿瘤和颌面疾病。详细情况见报告。共有597名患者被直接转诊至合适的护理机构，574名患者可在诊所层面得到全面管理。
本研究证明了小儿外科疾病是一个重大的公共卫生问题。它强调了基层医疗保健层面外科诊所的预防和成本效益作用。该诊所对65%的外科病例进行了及时的手术干预，从而减少了不适当的三级转诊。我们认为让专家走进社区只会加强2010年的医疗保健计划。
