Utilization of emergency care by pre-school children in Stockholm suburbs

The number of emergency visits (i.e. visits on the same day as the first contact for the problem in question was taken) by a defined population of pre-school children in Stockholm was studied during three months in 1977 and 1982. The aim was to describe the pattern of utilization of care. In 1982 we wanted to study whether instructions to integrate preventive and curative care at Child Health Centres (CHCs) had altered this pattern. All visits to nurses and physicians providing emergency care for children were recorded. The total number of visits was 33 per 1 000 children per week in 1977, and 39 (age-adjusted) in 1982. The increase was attributed to visits to the Child Health Centres. Thirteen and 28% of all the visits, respectively, were paid to the CHC nurses. Considering visits to a physician, there was only a slight increase from 1977 to 1982. In 1977 20% of the visits to a physician occurred within the primary health care organization. In 1982 the figure was 41%. A 29% decrease was recorded for the emergency services at the hospitals, from 1977 to 1982. Our findings show that the nurses at the Child Health Centres are a very important but little recognized resource for the care of sick children. At the CHCs the services are usually established in a way that follows the principles agreed on for the primary health care. It would seem suitable to use these resources also for curative care.