Elliott M, Jones J C, Jones R, Pritchard V G, Robinson B E
Chester and Halton Community Trust.
Public Health. 1994 May;108(3):203-10. doi: 10.1016/s0033-3506(94)80118-5.
An inter-district audit was carried out on the benefit to children of universal school entry medical examination, the appropriate use of professional time and to establish a baseline against which to measure future changes in services to under-fives and schoolchildren. The school health records of 1127 Cheshire schoolchildren, a random 10% sample, were scrutinised. There were significant district variations. Overall, 45% of children had problems not previously noted: 21% were serious enough to be referred; 11% could have had their problems managed by a well-trained school nurse but 9.8% would have required a medical examination for detection and assessment. These included conditions such as undescended testes, heart murmurs, squints and hernias and 8% required immediate action. The selection criteria, based on the absence of a three-year health check and/or parental or nurse concern, would have failed to identify 217 of the 491 children with new problems, some of which were serious. Targeting only an area of high deprivation or poor health would equally miss significant conditions. The inter-district variation of the numbers and diagnoses of new problems detected at school entry, and the difficulty in predicting which children will have important conditions, provide a good case for the continuation of the school entry medical examination for all children.
开展了一项跨地区审计，以评估普及入学体检对儿童的益处、专业时间的合理使用情况，并建立一个基线，用以衡量未来针对五岁以下儿童和学童服务的变化。对柴郡1127名学童（随机抽取的10%样本）的学校健康记录进行了审查。各地区存在显著差异。总体而言，45%的儿童存在之前未被注意到的问题：其中21%的问题严重到需要转诊；11%的问题本可由训练有素的学校护士处理，但9.8%的问题需要进行医学检查以进行检测和评估。这些问题包括隐睾、心脏杂音、斜视和疝气等情况，8%的问题需要立即采取行动。基于没有进行三年健康检查和/或家长或护士的担忧的选择标准，会遗漏491名有新问题儿童中的217名，其中一些问题很严重。仅针对高贫困或健康状况差的地区也会遗漏重大疾病情况。入学时新发现问题的数量和诊断的地区差异，以及难以预测哪些儿童会有重大疾病情况，为继续对所有儿童进行入学体检提供了有力理由。
