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[Chronic diseases in the paediatric population: Comorbidities and use of primary care services]
Jaime Barrio Cortes1, Carmen Suárez Fernández2, Mariana Bandeira de Oliveira3
1Programa de Doctorado en Medicina y Cirugía, Universidad Autónoma de Madrid, Madrid, España; Unidad de Apoyo a la Investigación, Gerencia Asistencial de Atención Primaria, Madrid, España.
Insights
Chronic paediatric patients in primary care, including those with asthma, ADHD, and obesity, utilize services frequently. Younger age, multiple conditions, and frequent contacts increase complexity, impacting care management.
Area of Science:
- Pediatrics
- Primary Care
- Health Services Research
Background:
- Adjusted Morbidity Groups (AMG) are utilized for stratifying chronic patients in Primary Care (PC).
- Understanding the characteristics and healthcare utilization of chronic paediatric patients is crucial for effective resource allocation.
Purpose of the Study:
- To describe the characteristics and comorbidity prevalence of chronic paediatric patients in PC.
- To analyze factors associated with complexity weight using AMG in this population.
- To assess the utilization of PC services by chronic paediatric patients.
Main Methods:
- A cross-sectional study was conducted on paediatric patients (<18 years) classified as chronic using Madrid PC's AMG.
- Data collected included sociodemographic, clinical-care variables, and PC service usage.
- Univariate, bivariate, and linear regression analyses were performed to identify factors associated with complexity.
Main Results:
- 15.7% of 2,961 paediatric patients were identified as chronic, with 96.5% being low-risk.
- The most prevalent conditions were asthma (6.1%), ADHD (1.8%), and obesity (1.4%).
- Younger age (<5 years), increased number of chronic diseases, and higher PC contact frequency were associated with greater complexity weight.
Conclusions:
- A notable proportion of the paediatric population has chronic diseases, with asthma, ADHD, and obesity being most common.
- Chronic paediatric patients exhibit high utilization of PC services.
- Complexity in this group is linked to younger age, multiple morbidities, and frequent healthcare interactions, highlighting the need for tailored care pathways.
Introduction:
Adjusted morbidity groups (AMG) are being used in the stratification of chronic patients in Primary Care (PC). The aim of this study was to describe the characteristics, prevalence of comorbidities, and use of PC services by chronic paediatric patients as well as to analyse factors associated with the weight of complexity according to AMG.
Patients And Methods:
A cross-sectional study conducted on patients <18 years-old from a basic health area, classified as chronic according to the AMG of the Madrid Primary Care computerised clinical records. Sociodemographic and clinical-care variables were collected, as well as the use of services in PC. Univariate, bivariate and linear regression analysis were performed.
Results:
A total of 2,961 patients<18 years were included, of whom 423 (15.7%) were identified as chronic, and 408 (96.5%) were low risk patients. Their mean age was 9.5 (SD=4.7) years, and 54.1% were male. The mean of chronic diseases was 1.1 (SD=0.4) and 11.3% had multiple morbidity. The most prevalent diseases were asthma (6.1%), attention deficit hyperactivity disorder (ADHD) (1.8%), and obesity (1.4%). The mean number of visits to the paediatrician was 4.9 (SD=6.3). Age<5 years-old (Coefficient B [CB]=2.6, 95% CI=2.1, 3.1), number of chronic diseases (CB=1.6, 95% CI=1.1; 2.1), and annual contacts with PC (CB=0.1, 95% CI=0.06; 0.11) were associated with greater complexity weight.
Conclusions:
A significant number of patients with chronic diseases were found in the paediatric population. The most prevalent diseases were asthma, ADHD, and obesity. The use of PC services was high. The greatest complexity corresponded to nursing and pre-school age, multiple morbidity, and higher number of contacts with PC.
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