Sillanpää Matti, Saarinen Maiju M, Lähdesmäki Tuire
Department of General Practice University of Turku Turku Finland.
Department of Child Neurology Turku University Hospital Turku Finland.
Epilepsia Open. 2020 Oct 12;5(4):574-581. doi: 10.1002/epi4.12436. eCollection 2020 Dec.
The aim of the study was to describe healthcare organization, training of and needs for child neurologists, patient accessibility to services, and treatment paths of children with epilepsy in Finland.
Data were collected from all geographic healthcare areas over Finland on training capacity in child neurology, number and density of child neurologists, and availability and accessibility of child neurological services. Data sources included the National Physician Register, Central Register of Healthcare Professionals of National Supervisory Authority for Welfare and Health, and phone and email inquiries to the heads of public healthcare units.
The overall density of child neurologists in Finland was 11.9/100 000 children aged 0-15 years or 8402 children per child neurologist (in 2018). There is a remarkable geographic variation, from 7.1 in northern Finland to 15.6 in the metropolitan area. However, waiting times for the treatment are virtually the same all over the country. According to the Finnish current practice recommendation from the year 2013 and again 2020, children with any first nonfebrile or complicated febrile epileptic seizure are invariably admitted to hospital for evaluation. Children with simple febrile seizures are recommended to be treated as outpatients by general practitioners or by experienced pediatricians.
Child neurology services are today well provided and organized in Finland. While there is geographic variation in the number of child neurologists, the accessibility is virtually the same all over the country. A gap between the numbers of specialists at near-to-retire age and those in training is a challenge.
本研究旨在描述芬兰儿童神经科医生的医疗保健机构、培训情况及需求、患者获得服务的途径以及癫痫患儿的治疗路径。
收集了芬兰所有地理区域医疗保健领域关于儿童神经病学培训能力、儿童神经科医生数量及密度、儿童神经科服务的可获得性和可及性的数据。数据来源包括国家医师登记册、福利与卫生部国家监管局医疗保健专业人员中央登记册，以及对公共医疗保健单位负责人的电话和电子邮件询问。
芬兰儿童神经科医生的总体密度为每10万名0至15岁儿童中有11.9名，即每名儿童神经科医生负责8402名儿童（2018年）。存在显著的地理差异，从芬兰北部的7.1名到大都市区的15.6名。然而，全国各地的治疗等待时间几乎相同。根据芬兰2013年和2020年的现行实践建议，任何首次出现非热性或复杂性热性癫痫发作的儿童都一律住院接受评估。建议简单热性惊厥患儿由全科医生或经验丰富的儿科医生作为门诊患者进行治疗。
如今芬兰的儿童神经科服务提供良好且组织有序。虽然儿童神经科医生的数量存在地理差异，但全国各地的可及性几乎相同。接近退休年龄的专家数量与正在接受培训的专家数量之间的差距是一个挑战。
