Preschool Children as Frequent Attenders in Primary Health Care in Croatia: Retrospective Study

Abstract

Aim To define predictive factors for frequent attenders among preschool children in primary health care and investigate the association between socioeconomic factors and medical factors, as well as the reasons for child's appointment in the physician's office.Methods This retrospective study was conducted in 7 primary health care offices (6 family physician practices and 1 pediatric practice) in Zagreb, Croatia. The study included 964 preschool children from 1-6 years who visited these practices during 2005. Children in the highest quartile of consultation frequency (n = 255) were defined as frequent attenders, while the children in the lowest quartile of consultation frequency (n = 302) represented the control group (non-frequent attenders). We collected data on consultation rate, socioeconomic factors, health care providers, prescriptions and referrals, symptoms, and diagnoses. Association of the parameters and the frequency of consultations was investigated by logistic regression analysis.Results Frequent attenders sought for consultations 10 times per year (median, range 4-26), and they had the following characteristics: had 2-3 years, attended day care center, were treated by a pediatrician, and received more prescriptions and referrals. Their major complaints were: cough, nasal discharge, rash, fever, difficult breathing, earache, digestive problems, throat soreness, and injuries. Logistic regression analysis showed significant association between frequent attendance and age of 2-3, the symptom of nasal discharge, and diagnoses of infectious and parasitic diseases, middle ear diseases, respiratory system diseases, and skin and subcutaneous tissue diseases.Conclusion Socioeconomic characteristics, symptoms, and diagnoses were important predictors for defining preschool frequent attenders in primary health care.

Children and Adolescents as Patients in General Practice - The Reasons for Encounter

“…This was also stated by others [13]. More young children (0 - 4 years) suffered from illness generally and consultation rates differed widely according to symptoms [12].…”

Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children

“…Acute respiratory infections (ARI) are the most frequent childhood diseases in Western countries, and the most common reason for children to visit health care professional. [1][2][3] Still, most ARI in children resolve spontaneously and in about 50% of cases do not lead to consultation of a paediatrician. [4][5][6] As a consequence, assessing the full burden of these infections cannot solely be based on physicians' reports.…”

“…Studies assessing the frequency of ARI in the population try to overcome this limitation by including other data sources. In the past, four different data collection methods have been used: (1) hospital visits every time the child has symptoms 7 , (2) retrospective surveys via parent-administered questionnaires or interviews 8-11 , (3) parent-administered prospective symptom diaries 5,6,12,13 , and (4) a combination of parent-administered prospective symptom diaries and interviews. 14,15 However, a definition of ARI episodes for these additional data sources is more difficult to apply than simply to rely on physician reports.…”

Welcome back? Frequent attenders to a pediatric primary care center

“…Factors associated with these barriers include lack of financial resources and third party coverage, socioeconomic status, and ethnicity. One of the effects of these barriers both for adults and children (Byrne et al, 2003;Chan and Ovens, 2002;Coffman et al, 2008;Hanasagi et al, 2001;Lucas and Sanford, 1998;Pines and Buford, 2006;Stanley et al, 2007;Stojanovic-Spehar et al, 2007;Zuckerman and Shen, 2004) is frequent use of emergency departments (ED) for non-emergency illness or failure to seek care at all until hospitalization is required. In contrast to overuses of the ED, there is also a population of patients who do have access to primary care that seeks these services with greater frequency than their medical conditions warrant (Bergh and Marklund, 2003;Fallon et al, 2007;Foster et al, 2006;Jyvasjarvi et al, 1998;Scaife et al, 2000).…”