Description of the medical services provided to children in Shanghai: a cross-sectional study of the characteristics and disparities of hospitals of different levels and types

Yihui Zhai; Liangfeng Tang; Yonghao Gui; Yingzi Ye; Danping Gu; Rui Feng; Xiaobo Zhang

doi:10.21037/tp-22-300

Description of the medical services provided to children in Shanghai: a cross-sectional study of the characteristics and disparities of hospitals of different levels and types

Transl Pediatr. 2023 Apr 29;12(4):560-571. doi: 10.21037/tp-22-300. Epub 2023 Mar 20.

Authors

Yihui Zhai^#^{1

2}, Liangfeng Tang^#^{3

4}, Yonghao Gui^{5

6}, Yingzi Ye^{5

7}, Danping Gu⁸, Rui Feng^{1

9}, Xiaobo Zhang^{5

10}

Affiliations

¹ Department of Statistics and Data Management, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
² Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
³ Department of Information Technology and Management, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
⁴ Department of Urology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
⁵ Center for Pediatric Clinical Quality Control of Shanghai, Shanghai, China.
⁶ Department of Cardiology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
⁷ Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
⁸ Center for Medical Quality Control of Shanghai, Shanghai, China.
⁹ Shanghai Key Laboratory of Intelligent Information Processing, School of Computer Science, Fudan University, Shanghai, China.
¹⁰ Department of Pulmonology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

^# Contributed equally.

Abstract

Background: The development of the pediatric care system is uneven in China. Limited research has been conducted on pediatric care in Shanghai, which is a well-developed region in China, in which the National Children's Medical Centers are located.

Methods: In November 2021, under the commission of the Shanghai Center for Medical Quality Control, a city-wide questionnaire designed to examine the provision of medical services to children in Shanghai in 2020 was conducted at 86 hospitals providing pediatric care. The overall characteristics and disparities between the general hospitals and children's hospitals and suggestions for future developments were explored.

Results: In 2020, there were 86 hospitals providing pediatric care, covering all 16 municipal districts of Shanghai, with an average distribution of 1.4 hospitals per 100 km². The hospitals were mainly public (94.2%) and general (96.5%) hospitals. With a response rate of 90.7%, the questionnaire results revealed that there were 2,683 in-service pediatricians in Shanghai, with an average of 1.1 pediatrician per 1,000 children aged 0-14 years in Shanghai. The pediatricians were mainly women (71.8%), aged 40 years or younger (60.6%), who held a bachelor's degree or higher (99.5%). The total number of pediatric outpatient and emergency visits was approximately 8 million, with an average of 2,973 visits per pediatrician in 2020. There were >370,000 visits to fever clinics. The number of pediatric inpatient visits exceeded 160,000, with an average hospital stay length of 5.8 days. The uneven development between the children's hospitals and general hospitals represents a major challenge facing Shanghai's pediatric care system, and the close links between the 2 types of hospitals need to be further strengthened.

Conclusions: Shanghai provides an overall superior medical service to children in China. The close link between the children's hospitals and general hospitals should be further strengthened to optimize the distribution of high-quality resources and greatly improve the overall provision of pediatric medical services.

Keywords: Medical services; Shanghai; children; pediatric care.