[Psychosocial aspects associated with excessive attendance in primary care paediatric clinics]

[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.

Children as frequent attenders in primary care: a systematic review

Background

Frequent paediatric attendances make up a large proportion of a GP's workload. Currently, there is no systematic review on frequent paediatric attendances in primary care.

Aim

To identify the sociodemographic and clinical characteristics of children who attend primary care frequently.

Design & setting

A systematic review.

Method

The electronic databases MEDLINE, Embase, and PsycINFO were searched up to January 2020, using terms relating to frequent attendance in primary care settings. Studies were eligible if they considered children frequently attending in primary care (aged 0–19 years). Relevant data were extracted and analysed by narrative synthesis.

Results

Six studies, of fair quality overall, were included in the review. Frequent attendance was associated with presence of psychosocial and mental health problems, younger age, school absence, presence of chronic conditions, and high level of anxiety in their parents.

Conclusion

Various sociodemographic and medical characteristics of children were associated with frequent attendance in primary care. Research on interventions needs to account for the social context and community characteristics. Integrating GP services with mental health and social care could potentially provide a response to medical and psychosocial needs of frequently attending children and their families.