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Children as frequent attenders in primary care: a systematic review
Mohammed N Al-Saffar1, Benedict Wj Hayhoe2, Matthew J Harris2
1Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK m.al-saffar@imperial.ac.uk.
Insights
Frequent pediatric primary care visits are linked to psychosocial issues, younger age, and parental anxiety. Understanding these factors is key for effective interventions in children’s healthcare.
Area of Science:
- Pediatric primary care
- General practice workload
- Child health services
Background:
- Frequent pediatric attendances represent a significant component of general practitioner (GP) workload.
- A systematic review on frequent pediatric attendances in primary care is currently lacking.
Purpose of the Study:
- To identify sociodemographic and clinical characteristics of children with frequent primary care attendances.
- To inform targeted interventions for high-utilizing pediatric populations.
Main Methods:
- Systematic review of studies identified through MEDLINE, Embase, and PsycINFO databases up to January 2020.
- Inclusion criteria: studies on children (0-19 years) with frequent primary care attendance.
- Data synthesis: narrative analysis of extracted information.
Main Results:
- Six fair-quality studies were included.
- Frequent attendance associated with psychosocial and mental health problems.
- Associated factors include younger age, school absence, chronic conditions, and parental anxiety.
Conclusions:
- Sociodemographic and medical factors are associated with frequent pediatric primary care attendance.
- Intervention research must consider social context and community characteristics.
- Integration of GP, mental health, and social care services is recommended for addressing needs of frequently attending children and families.
Background:
Frequent paediatric attendances make up a large proportion of a GP's workload. Currently, there is no systematic review on frequent paediatric attendances in primary care.
Aim:
To identify the sociodemographic and clinical characteristics of children who attend primary care frequently.
Design & Setting:
A systematic review.
Method:
The electronic databases MEDLINE, Embase, and PsycINFO were searched up to January 2020, using terms relating to frequent attendance in primary care settings. Studies were eligible if they considered children frequently attending in primary care (aged 0-19 years). Relevant data were extracted and analysed by narrative synthesis.
Results:
Six studies, of fair quality overall, were included in the review. Frequent attendance was associated with presence of psychosocial and mental health problems, younger age, school absence, presence of chronic conditions, and high level of anxiety in their parents.
Conclusion:
Various sociodemographic and medical characteristics of children were associated with frequent attendance in primary care. Research on interventions needs to account for the social context and community characteristics. Integrating GP services with mental health and social care could potentially provide a response to medical and psychosocial needs of frequently attending children and their families.
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