[Work of a district pediatric service for young children: analysis, problems, solutions]

Area of Science:

• Pediatrics
• Public Health
• Healthcare Management

Background:

• Current healthcare systems often allocate pediatrician time predominantly to curative care for sick children.
• Preventive care for high-risk infant populations, crucial for early health intervention, receives inadequate attention.
• Analysis of pediatrician working time in Nizhniy Novgorod polyclinics revealed significant time constraints.

Purpose of the Study:

• To analyze the time allocation of district pediatricians in outpatient settings.
• To identify deficiencies in preventive care for infants, particularly those at risk.
• To propose organizational changes to enhance preventive pediatric services.

Main Methods:

• Data collection on curative and preventive care for 1740 infants.
• Time-motion study of district pediatricians in two polyclinics.
• Qualitative analysis of pediatrician workload and service delivery.

Main Results:

• Pediatricians dedicate the majority of their time to treating sick children.
• Minimal time is allocated to the follow-up and preventive care of "at-risk" infant groups.
• Current practices limit the effectiveness of preventive health strategies for young children.

Conclusions:

• The current distribution of pediatrician time is suboptimal for comprehensive child health.
• Establishing dedicated young child departments within territorial polyclinics is proposed.
• These departments are expected to significantly improve key indicators of child health and preventive care quality.