探讨新型冠状病毒肺炎疫情对儿科门诊和急诊就诊情况的影响及其可能原因，为未来优化儿童就医模式、实现儿童分级诊疗提供参考。

对2020年2月25日在北京大学第一医院儿科门诊和急诊就诊的儿童及其家属、接诊医师进行问卷调查。方便抽样法抽取疫情期间在儿科门诊和急诊出诊的儿科医师，采用专题小组半结构访谈法进行资料收集。

共回收合格问卷77份，应答率为87.5%。调查问卷结果显示，40例（51.9%，40/77）未带患儿仅家长前来门诊和急诊就诊，44例（57.2%，44/77）为了开药/咨询就诊。33例（42.8%，33/77）非开药/咨询就诊的儿童中，前5位主诉是发热、咳嗽、皮疹、黄疸和早产儿随访，前5位诊断疾病是肺炎、化脓性扁桃炎、上呼吸道感染、新生儿黄疸和早产儿随访，治疗以回家观察和口服药物为主，占75.6%（25/33）。33例患儿中，接诊医师认为没有必要来医院、可就诊于合格的初级医疗机构有13例（39.4%），认为线上咨询能解决部分问题有21例（63.6%），认为在线咨询完全能解决患儿的问题有5例（15.2%）。对6名出诊的儿科医师定性访谈结果显示，新型冠状病毒肺炎疫情发生后，儿科门诊和急诊患儿数量明显减少，急诊患儿病情较以往复杂，门诊患儿病情较以往简单，医患关系更加和谐，未来应采取多种措施促进三级医院儿科/儿童医院门诊和急诊患儿的分流。

新型冠状病毒肺炎疫情对于综合医院儿科门诊和急诊患儿及其家长的就医行为影响巨大，未来应通过加强医学科普、发展在线医疗、合理解决慢性病患者取药问题、加强医师培训、发展医联体等多种途径，优化医疗资源配置，改善儿童就医模式，推动儿童分级诊疗的实施。

To investigate the impact of COVID-19 epidemic on pediatric outpatient and emergency department and the possible causes, to provide reference for optimizing children′s medical-seeking pattern and achieving children′s hierarchical diagnosis and treatment.

A self-designed questionnaire was used to investigate the children who visited the pediatric outpatient or emergency department of Peking University First Hospital from 08:00 on February 25, 2020 to 08:00 on the next day, as well as their accompanying relatives and corresponding doctors. A semi-structured interview method was used to collect data from pediatricians responsible for the outpatient and emergency department during the COVID-19 epidemic.

A total of 77 valid questionnaires were returned with a response rate of 87.5%, which showed that almost half of the children (51.9%, 40/77) were absent and their parents described the main complaints. Forty-four (57.2%, 44/77) visits resulted from consulting/prescription, and the other 33 (42.8%, 33/77) were led by various complaints, among which the five leading complaints were fever, cough, rash, jaundice, and premature baby follow-up, the five leading diseases were pneumonia, suppurative tonsillitis, upper respiratory infection, neonatal jaundice, and the follow-up of premature infants. Of these 33 visits, 13 (39.4%) cases were evaluated by their corresponding doctors as being able to get diagnosed and treated at a qualified primary medical institution instead of coming here, and 21 (63.6%) and 5 (15.2%) cases were considered to be able to get some and all problems solved through online consultation, respectively. The qualitative interview results showed that since the outbreak of COVID-19, the number of children visiting outpatient or emergency department had reduced significantly. Compared with the situation before the epidemic, the conditions of children visiting emergency department became more complicated, while those of children visiting outpatient department became simpler. Meanwhile, the doctor-patient relationship became more harmonious. In the future, multiple measures should be taken to promote the triage of outpatient and emergency patients visiting pediatrics department of tertiary hospitals or Children′s Hospital.

The epidemic of COVID-19 has a huge impact on the health-seeking behavior of children and their parents in the outpatient and emergency department of general hospitals. In the future, we should strength medical science education for parents, develop online medical consultation, improve the routes of drug availability for chronic disease patients, strengthen doctor training, and develop medical conjoined body, so as to change the children′s medical care behavior and promote the implementation of hierarchical medical system in children.