[Delivery of care pressure, frequency of attendance and pediatric morbidity at a health center. Age and seasonal variations].

OBJECTIVE

To inform on the demand for primary care paediatric services, with a view to improving health care delivery.

DESIGN

Observational retrospective study.

SETTING

Estella Health Centre (Navarra).

PATIENTS

All patients attended during 1999 at one of the two paediatric clinics at the health centre. They were divided by ages into breast-feeders (0-12 months), pre-school (1-5 years old), primary school (6-9) and adolescents (10-14).

MEASUREMENTS

The date, sex, age, type of consultation (on demand/scheduled) and health problem (CIPSAP-2) of the 6611 consultations were recorded. Frequency of visits, care pressure and seasonal distribution, related to age and type of consultation, were calculated.

RESULTS

There were 4600 on-demand consultations (69.6%) and 2011 scheduled ones (30.4%). Total frequency of attendance was 5.46, which was greater in on-demand pre-school children (6.4) and scheduled breast-feeders (13.3). Overall patient pressure was 28.2, though less (p < 0.05) in the summer months. The most common health problems in on-demand consultations were respiratory illnesses (52.8%), infectious diseases (7.5%), neuro-sensory problems (6.8%), accidents (6.0%) and digestive problems (4.7%). There was negative correlation (p < 0.05) between age and the prevalence of respiratory diseases, whereas age was directly proportional (p < 0.05) to the prevalence of accidents and locomotive illnesses. Respiratory and infectious diseases were more common (p < 0.05) in the autumn and winter months.

CONCLUSIONS

Paediatrics at a health centre suffers patient overload, with acute illnesses of the respiratory apparatus, and to a lesser extent infectious diseases, the main causes of consultation. Health check-ups are becoming steadily more important. There needs to be better coordination between PC teams in order to unify diagnostic and therapeutic criteria, for the more thorough non-hospital paediatrics becomes, the greater its effect on improving child health quality.