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Trends in childhood illness and treatment in Australian general practice, 1971-2001
Janice Charles1, Ying Pan, Helena Britt
1General Practice Statistics and Classification Unit, Family Medicine Research Centre, University of Sydney, Westmead Hospital, Wentworthville, NSW. janc@med.usyd.edu.au
Insights
Australian children are increasingly vaccinated and less likely to see general practitioners for common childhood illnesses. Management trends show shifts in treatment approaches, with more advice and less medication prescribed.
Area of Science:
- Pediatric Health
- General Practice Research
- Epidemiology
Background:
- Childhood illness patterns and management in Australian general practice have evolved over decades.
- Understanding these changes is crucial for public health and primary care strategies.
- Previous studies provide a baseline for comparison of current trends.
Purpose of the Study:
- To analyze shifts in the morbidity and management of diseases among children in Australian general practice.
- To compare current pediatric health trends with historical data from 1971 and 1990-91.
Main Methods:
- A comparative analysis of general practice consultations for children under 15.
- Utilized cross-sectional survey data from 1990-91 and 2000-01.
- Included a descriptive comparison with a 1971 study.
Main Results:
- Increased management rates for vaccinations and allergic dermatitis were observed.
- Decreased management rates for acute otitis media, asthma, tonsillitis, bronchitis, and gastroenteritis.
- Antibiotic and respiratory medication prescribing declined, while vaccine and corticosteroid prescribing increased.
- Counselling and advice became more frequent, with a decrease in medication prescription.
Conclusions:
- Australian children are now generally well-vaccinated.
- There is a reduced likelihood of children presenting to general practitioners with "traditional" childhood illnesses.
- Management strategies have shifted towards preventative care and reduced medication use.
Objective:
To determine changes in morbidity and management of disease in children in Australian general practice.
Design And Setting:
A comparative study of general practice consultations in children under 15 years, using data from cross-sectional general practice surveys (1990-91 and 2000-01), and a descriptive comparison with a similar study from 1971.
Main Outcome Measures:
Relative rates of management (rate/100 general practice encounters) of the most common children's problems and treatments.
Results:
Problems with significantly higher management rates in 2000-01 compared with 1990-91 included vaccination (11.1 v 7.6 per 100 encounters in 1990-91) and contact/allergic dermatitis (3.1 v 2.5). Those managed significantly less often in 2000-01 v 1990-91 included acute otitis media (7.7 v 9.4), asthma (5.4 v 8.8), tonsillitis (4.4 v 6.0), acute bronchitis (3.8 v 5.3) and gastroenteritis (1.7 v 2.7). Asthma management rates rose from 2.4% of all problems managed in 1971 to 7.2% in 1990-91, then fell in 2000-01 to 4.6%. More frequent rates of counselling and advice in 2000-01 (28.4% of encounters v 22.9% in 1990-91) were associated with a decrease in rates of prescribing and supply of medication (56.6% of encounters v 64.3% in 1990-91). Antibiotic prescribing declined significantly (from 33.8 per 100 encounters in 1990-91 to 25.2 in 2000-01), as did prescribing of respiratory medications (from 15.5 to 9.9 per 100 encounters), while prescribing of vaccines and systemic corticosteroids doubled (from 9.6 to 18.8 per 100 encounters, and from 0.6 to 1.2, respectively). (All comparisons between 1990-91 and 2000-01 are significant at P < 0.01.)
Conclusions:
These findings point to the emergence of a generation of Australian children who are generally well vaccinated and are less likely to present to GPs with "traditional" childhood illnesses.
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