¿De qué hablan los pediatras y las madres en la consulta de seguimiento de la salud infantil?

[Differences in use of health care time between Spanish-born and immigrant child population in two regions of the Basque Country]

INTRODUCTION

The aim of the study was to analyse the frequency and time of consultation in Primary Care and in paediatric hospital emergencies, between the native (Spanish-Born) paediatric population and children of immigrant origin, as well as its relationship with socioeconomic variables.

PATIENTS AND METHODS

The retrospective observational cohort study was conducted on 301 children in two regions of the Basque Country (Gipuzkoa). The immigrant population was represented following the proportion of nationalities distribution in 2011. The native population had the same age distribution as the immigrant origin population. The sample was selected by simple randomisation. Frequency and consultation time data were obtained through the administrative databases. An ad hoc face-to-face survey, addressed to the guardians of the study subjects, was carried out in order to obtain socio-economic data.

RESULTS

No differences were observed in frequency or mean duration of the consultation visits. The profile of the significantly more frequent child in Primary Care responded to children from 0 to 6 years old, with maximum one sibling. This profile was repeated when attending hospital emergencies. On the other hand, as regards outpatient consultation time, the relationship between mothers with a high education level or university degree and longer duration of Primary Care visits was highlighted.

CONCLUSIONS

Age, the number of siblings, and mother's education level were the variables that have best explained the variability in terms of frequency and time of consultation, affecting both groups of children equally and in the same direction.

Priority setting in paediatric preventive care research

OBJECTIVES

To identify the unanswered research questions in paediatric preventive care that are most important to parents and clinicians, and to explore how questions from parents and clinicians may differ.

DESIGN

Iterative mixed methods research priority setting process.

SETTING

Toronto, Ontario, Canada.

PARTICIPANTS

Parents of children aged 0-5 years enrolled in a research network in Toronto, and clinicians practising in Toronto, Ontario, Canada.

INTERVENTIONS

Informed by the James Lind Alliance's methodology, an online questionnaire collected unanswered research questions in paediatric preventive care from study participants. Similar submissions were combined and ranked. A consensus workshop attended by 28 parents and clinicians considered the most highly ranked submissions and used the nominal group technique to select the 10 most important unanswered research questions.

RESULTS

Forty-two clinicians and 115 parents submitted 255 and 791 research questions, respectively, which were combined into 79 indicative questions. Most submissions were about nutrition, illness prevention, parenting and behaviour management. Parents were more likely to ask questions about screen time (49 parents vs 8 clinicians, p<0.05) and environmental toxins (18 parents vs 0 clinicians, p<0.05). The top 10 unanswered questions identified at the workshop related to mental health, parental stress, physical activity, obesity, childhood development, behaviour management and screen time.

CONCLUSION

The top 10 most important unanswered research questions in paediatric preventive care from the perspective of parents and clinicians were identified. These research priorities may be important in advancing preventive healthcare for children.