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Changing morbidity patterns in children in Dutch general practice: 1987-2001
Hanneke B M Otters1, Johannes C van der Wouden, François G Schellevis
1Department of General Practice, Erasmus University Medical Center, Rotterdam, Netherlands.
Insights
Childhood morbidity in the Netherlands shows a shift, with fewer general practice consultations. Skin diseases are increasingly common, while respiratory issues are declining in children.
Area of Science:
- Pediatrics
- General Practice
- Public Health
Background:
- Childhood morbidity patterns evolve over time.
- General practice serves as a key indicator of community health trends.
- Understanding these shifts is crucial for pediatric healthcare planning.
Purpose of the Study:
- To compare childhood morbidity patterns in Dutch general practice between 1987 and 2001.
- To analyze changes in consultation rates and disease prevalence.
- To identify trends in common childhood illnesses.
Main Methods:
- Utilized data from two cross-sectional surveys of children (0-17 years) in Dutch general practices (1987 and 2001).
- Compared consultation rates and analyzed disease episodes using the International Classification of Primary Care (ICPC).
- Stratified analyses by ethnicity and compared incidence rates of prevalent diseases.
Main Results:
- Childhood consultation rates decreased from 2.7 to 2.1 visits per child annually.
- Respiratory problems remained most frequent but decreased proportionally (25.5% to 23.3%).
- Skin problems increased significantly (17.8% to 23.0%), particularly among Western children, with higher incidence of specific skin diseases.
Conclusions:
- Childhood morbidity in Dutch general practice has demonstrably changed between 1987 and 2001.
- Skin diseases have gained prominence, while respiratory conditions have become less prevalent.
- These findings highlight an evolving landscape of pediatric health concerns in primary care settings.
Objectives:
To examine the presentation and pattern of childhood morbidity in general practice compared with 14 years ago.
Methods:
We used data of all children aged 0-17 years from two cross-sectional surveys performed in 1987 and 2001 in general practice in the Netherlands. The total number of children in the practices participating in these surveys were 86,577 children in 1987 and 82,053 children in 2001. First of all, we compared consultation rates of children in general practice. Secondly, childhood morbidity was assessed by episodes of disease, coded according to the International Classification of Primary Care (ICPC). We compared childhood morbidity in 1987 and 2001 by assessing the distribution of episodes among ICPC chapters stratified by ethnicity, and by comparing incidence rates of most frequently presented diseases.
Results:
Childhood consultation rates have decreased from 2.7 visits a year per child in 1987 to 2.1 in 2001. The distribution of episodes among ICPC chapters had also changed. Respiratory problems are still the most frequently presented health problem in children but the proportion has decreased from 25.5% in 1987 to 23.3% in 2001. Skin problems were presented more often (23.0% in 2001 versus 17.8 in 1987), and Western children more often presented with skin problems than with respiratory problems in 2001. Incidence rates of most respiratory diseases have decreased and specific skin diseases (dermatomycosis, impetigo and eczema) were diagnosed more often.
Conclusion:
In the Netherlands, childhood morbidity has changed. Skin diseases have become more important in general practice and respiratory problems are declining.
