[Use of medical services. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

The use of operations, visits to doctors and early diagnostic tests for children are examples of different services selected from the whole spectrum of preventative and therapeutic health service provisions in childhood and adolescence. In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which is representative for Germany, 17,641 children and adolescents aged 0-17 or their parents were questioned on subjects such as their use of medical services. The use made of individual early diagnostic tests for children remains above the 90 % limit until the U7 test and drops to 89.0 % at U8, falling to 86.4 % at U9. 81 % of children took part in all the early diagnostic tests provided until age 6 (U3 to U9). Another 16 % only took advantage of some parts of this service and 3 % of the children never went to one of these check-ups. As was to be expected, the annual rate of visits to paediatricians drops as children get older from 95.1 % for 0-2-year-olds to 25.4 % of the 14-17-year-olds, while the rate of visits to general practitioners rises from 11.8 % to 53.1 %. If one tracks the rate of visits to specialist doctors all the way across childhood and adolescence, different paths emerge: while children aged 3-6 most often visit the ear, nose and throat doctor, at primary school age they mainly see opticians, and 14-17-year-olds most often visit doctors of internal medicine, dermatologists and surgeons. 37.1 % of the 0-17-year-old children and adolescents had undergone an operation. In order of declining frequency, the operations named were adenoidectomy (15.2 %), tonsillectomy (5.9 %), herniotomy (3.6 %) and appendectomy (2.4 %). Circumcisions had been carried out on 10.9 % of the boys. The different way medical services are used in different subgroups may not only depend on medical factors but also on social factors, medical attitudes and the availability of services provided.