放課後等デイサービスおよび児童発達支援事業所における医療的ケア児受入の関連要因

Factors of Accepting for Children Requiring Medical Care in After-school Daycare and Child Development Support Center: A Nationwide Survey

要旨

　目的：本研究は，放課後等デイサービスおよび児童発達支援事業所における医療的ケア児の受入有無の関連要因を検討することを目的とした．

　方法：2018年12月末日時点で放課後等デイサービスおよび児童発達支援事業所の検索サイトである「放デイどっとこむ」に掲載された，全国15,560か所の放課後等デイサービスおよび児童発達支援事業所のうち約10％に当たる1,556か所の事業所を無作為抽出した郵送質問票調査を実施した．

　結果：二項ロジスティック回帰分析の結果，医療的ケア児の受入有無の関連要因は，「訪問看護の併設（オッズ比（OR）＝4.55）」，「連携：地域のリソースが具体的にわかる（OR＝1.18）」，「看護師の人数（OR＝14.94）」であった．

　結論：放課後等デイサービスおよび児童発達支援における医療的ケア児の受入には，看護師の配置や医療的ケア児を地域で支えるための連携が関連していた．今後，医療福祉連携の推進と適切な職員配置の基準化が重要と示唆された．

　Aim: This study aimed to investigate the factors determining whether children in need of medical care are accepted into after-school daycare and child development support centers.

　Method: The study design was a cross-sectional study. A survey questionnaire was distributed to 1556 after-school daycare offices and child development support centers between January and February 2019. Statistical analyses were performed using the χ² test, Wilcoxon rank-sum test, and logistic regression.

　Results: There were 292 responses (response rate: 20.7%), of which 249 were complete enough to be analyzed. Factors related to the acceptance of children requiring medical care include “paralleled with visiting nursing offices (odds ratio (OR) = 4.55),” “cooperation: knowing local resources specifically (OR = 1.18),” and “the number of nurses (OR = 14.94).”

　Conclusion: According to this study, acceptance of children requiring medical care in after-school daycare and child development support centers was related to the arrangement of nurses and cooperation to support children with medical care in the community. Therefore, it is hoped that medical welfare cooperation and appropriate staffing will be promoted in the future.