Pols David Hj, Nielen Mark Mj, Bohnen Arthur M, Korevaar Joke C, Bindels Patrick Je
Lecturer, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Senior Researcher, NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
BJGP Open. 2018 Apr 7;2(1):bjgpopen18X101349. doi: 10.3399/bjgpopen18X101349. eCollection 2018 Apr.
Atopic eczema, asthma, and allergic rhinitis (AR) create a serious burden on general practice resources.
To investigate the use of general practice resources (that is, consultation visits, telephone contacts, and home visits) in children with physician-diagnosed atopic disorders (ADs).
DESIGN & SETTING: In a nested index-control study design, all children (here defined as individuals aged 2-18 years) listed in a representative general practice database were selected in 2014.
Children diagnosed with ADs were matched on age and sex with non-atopic controls within the same practice. For all the different groups, the number and frequency of children contacting the GP were calculated.
Of the children with atopic eczema ( = 15 202), 80% consulted the GP in 2014 (controls = 67%). Of the children with asthma ( = 7754), 80% consulted the GP (controls = 65%), and for children with AR ( = 6710), this was 82% (controls = 66%). Of the children with all three ADs, 91% consulted the GP (controls = 68%). On average, a child with atopic eczema contacted the GP 2.8 times/year (controls = 1.9); for children with asthma, the contact frequency was 3.0 (controls = 1.9); and for AR, 3.2 (controls = 1.9). For children with all three ADs, the contact frequency was 4.3 (controls = 2.0). Consultations related to the ADs investigated only explain a smaller part of the increased healthcare utilisation in atopic children.
Atopic children use more general practice resources compared to non-atopic children, yet frequently for morbidity or other health-related questions not related to one of the ADs.
特应性皮炎、哮喘和变应性鼻炎（AR）给全科医疗资源带来了沉重负担。
调查在被医生诊断为患有特应性疾病（ADs）的儿童中全科医疗资源（即门诊就诊、电话联系和家访）的使用情况。
在一项嵌套式索引对照研究设计中，2014年从一个具有代表性的全科医疗数据库中列出的所有儿童（此处定义为年龄在2至18岁的个体）中进行选择。
将被诊断患有ADs的儿童按年龄和性别与同一医疗机构内的非特应性对照儿童进行匹配。对于所有不同组，计算儿童联系全科医生的次数和频率。
在患有特应性皮炎的儿童（n = 15202）中，80%在2014年咨询了全科医生（对照组为67%）。在患有哮喘的儿童（n = 7754）中，80%咨询了全科医生（对照组为65%），对于患有AR的儿童（n = 6710），这一比例为82%（对照组为66%）。在患有所有三种ADs的儿童中，91%咨询了全科医生（对照组为68%）。平均而言，患有特应性皮炎的儿童每年联系全科医生2.8次（对照组为1.9次）；对于患有哮喘的儿童，联系频率为3.0次（对照组为1.9次）；对于AR，为3.2次（对照组为1.9次）。对于患有所有三种ADs的儿童，联系频率为4.3次（对照组为2.0次）。与所调查的ADs相关的咨询仅解释了特应性儿童医疗保健利用率增加的较小部分。
与非特应性儿童相比，特应性儿童使用更多的全科医疗资源，但通常是因为发病或其他与健康相关的问题，而这些问题与ADs之一无关。
