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Background Promoting hierarchical treatment is the key to solve the irrational utilization of pediatric medical resources, but there is a lack of relevant studies on the current status of implementation of hierarchical diagnosis and treatment for children. Objective To describe the healthcare-seeking behavior of children with upper respiratory tract infection, including number of visits and health-seeking institutions and explore the main influencing factors of first visit of priamry care (community health services) . Methods Two questionnaires were administered to the parents of children attending the pediatric outpatient department of the Third Affiliated Hospital of Sun Yat-sen University and the Community Health Service Center in Shipai Street, Tianhe District in the same administrative district from March to July in 2019 and from February to July in 2022 using convenience sampling method, respectively. The included subjects were divided into the 2019 group (n=419) and 2022 group (n=307) according to the survey time. The questionnaire on the healthcare-seeking behavior and its influencing factors of children with upper respiratory tract infection using Anderson model as a theoretical guide was involved, univariate and multivariate Logistic regression analyses were used to explore the influencing factors of the first visit of children with upper respiratory tract infection in primary care. Results Among the 419 participated children in 2019, 301 (71.84%) visited for the first time, 87 (20.76%) for the second time and 31 (7.40%) for the third time and fourth time, with 47.49%, 27.12% and 16.13% visited the conmmunity health services centers, respectively. Among the 307 participated children in 2022, 219 (71.34%) visited for the first time, 72 (23.45%) for the second time and 16 (5.21%) for the third time or fourth time, with 41.04%, 39.77% and 43.75% visited the conmmunity health services centers, respectively. The results of multivariate Logistic regression analysis showed that the nearest medical institution was not a community health service center〔OR=0.220, 95%CI (0.147, 1.056), P |