Aparicio Rodrigo M, Ruiz Canela J, Buñuel Álvarez JC, García Vera C, Esparza Olcina MJ, Barroso Espadero D, González Rodríguez P, Juanes Toledo B, Martínez Rubio V, Ortega Páez E. Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review.
Acta Paediatr 2020;
109:1989-2007. [PMID:
32311805 DOI:
10.1111/apa.15324]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/26/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022]
Abstract
AIM
The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care.
METHODS
MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus.
RESULTS
Fifty-four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists.
CONCLUSION
According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.
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