Bruusgaard D, Kise S A, Nilsson D
Department of General Practice University of Oslo, Norway.
Scand J Prim Health Care. 1993 Jun;11(2):147-50. doi: 10.3109/02813439308994918.
To describe health service consumption and to find out whether a series of possible explanatory variables can help us to predict the number of contacts among children.
A prospective study following a cohort of children during the first four years of life.
A municipality in southern Norway.
183 children born in the community from October 1979 to and including December 1980.
Direct and indirect encounters with general practitioners (GPs) from the bills to the national insurance office, outpatient encounters and hospital admissions from the hospital files, and episodes of illness as reported in postal questionnaires to the parents.
Each child had on average 10.6 GP contacts (2.6 per year), and the frequency of contacts decreased as they grew. Telephone contacts were almost as frequent as consultations at the doctor's surgery, and the doctors made more home visits to the youngest children. Of the contacts, 4/5 took place in the day time, but most of the home visits took place during the evening/night/weekend. Each child had 1.9 hospital contacts in 4 years, i.e. 0.3 admissions and 1.6 outpatient department contacts. The parents reported an average of 11.5 episodes of illness during the period, more than twice as many in the first year as in the last year. Information about sex, duration of breast feeding, smoking in the family, family history of allergy, parents' education, whether in kindergarten, and presence of psychosocial problems cannot help in predicting health care consumption.
The low number of contacts with GPs can partly be explained by the fact that the children also have contact with a well-baby clinic. In our study, a series of possible explanatory factors did not help us to predict the amount of health care consumption during the first four years of life.
描述卫生服务利用情况,并探究一系列可能的解释变量是否有助于预测儿童的就诊次数。
对一组儿童出生后的头四年进行前瞻性研究。
挪威南部的一个自治市。
1979年10月至1980年12月(含)在该社区出生的183名儿童。
从提交给国家保险办公室的账单中获取与全科医生(GP)的直接和间接接触次数,从医院档案中获取门诊就诊次数和住院次数,以及通过邮寄给家长的问卷所报告的疾病发作次数。
每个儿童平均有10.6次与全科医生的接触(每年2.6次),且随着年龄增长接触频率降低。电话联系的频率几乎与在医生诊所的会诊频率相同,医生对最小的儿童进行家访的次数更多。在这些接触中,五分之四发生在白天,但大多数家访发生在傍晚/夜间/周末。每个儿童在4年中有1.9次住院接触,即0.3次住院和1.6次门诊接触。在此期间,家长报告平均有11.5次疾病发作,第一年的发作次数是最后一年的两倍多。关于性别、母乳喂养时长、家庭吸烟情况、过敏家族史、父母教育程度、是否上幼儿园以及是否存在心理社会问题等信息,均无法帮助预测医疗保健利用情况。
与全科医生接触次数较少的部分原因可能是儿童也会去母婴保健门诊。在我们的研究中,一系列可能的解释因素并不能帮助我们预测儿童出生后头四年的医疗保健利用量。