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Community paediatrics moves on--an analysis of changing work patterns 1994-97
M E Blair1, C R Pullan, C E Rands
1School of Human Development, Division of Child Health, Queen's Medical Centre, Nottingham, UK.
Public Health
|April 29, 2000
Summary
Community paediatricians are seeing more children with developmental problems and disabilities. Their role is becoming more specialized, focusing on child growth, development, and social/behavioral pediatrics.
Area of Science:
- Pediatrics
- Community Health
- Child Development
Background:
- The role of community paediatricians has evolved.
- Child health surveillance has transferred to primary care.
- Increased training has influenced paediatrician specialization.
Purpose of the Study:
- Describe the current clinical workload of community paediatricians.
- Outline changes in the community paediatrician role.
- Examine reasons for these role changes.
Main Methods:
- Retrospective analysis of routinely collected data.
- Study period: 1994-1997.
- Setting: Nottingham community paediatric service.
Main Results:
- 36,710 appointments offered; 17% non-attendance.
- Most patients were pre-school children.
- Referrals primarily from health visitors (23%) and school nurses (29%).
- Increased cases of developmental problems, disability, and child protection issues.
- Shift towards health centre clinics (9.8% increase) over school settings.
- Inner city areas referred twice as many children as county areas.
Conclusions:
- Community paediatricians have a more specialized role.
- Focus areas include child growth, development, disability, and social/behavioral pediatrics.
- Role evolution linked to primary care transfer of surveillance and enhanced training.