[Evaluation of pediatric health by the Primary Health Insurance Fund (CPAM) of Paris: realization of multidisciplinary pediatric prevention].

Since 1970, the "Caisse Primaire d'Assurance Maladie de Paris" carries out free periodic health examinations of apparently healthy children aged 10 months, 2 years and 4 years. Routine medical check-up last 3.50 hours, and included 800 items recorded on computerized forms. Of the 15,000 children annually screened, 21% were found to be normal, and unsuspected medical diagnosis were made in 11,500 of these children (79%), despite one or more previous evaluations by a physician. Altogether 27,400 abnormalities were detected (mean: 2.2) with a high rate of missed diagnosis (87%). The majour risks of medical problems were, in the four-year age group: 1/ abnormal vision (32%) 2/ abnormal audiological examination (13%), 3/ abnormal behavior and delayed development test performance (22%), 4/ poor nutritional status, 43% being reported as iron-deficient anemic children. These results warrant the use of selected screening tests to determine the type of injuries amenable to future early preventive measures of Public Health.