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Chronic illness in childhood: a regional survey of care
Insights
Primary care physicians often refer children with chronic conditions to subspecialists. Rural general practitioners and pediatricians provide broader care but underutilize mental and social services for pediatric chronic illness management.
Area of Science:
- Pediatric Healthcare Delivery
- Chronic Illness Management in Children
- Primary Care Physician Practices
Background:
- Understanding the patterns of care for children with chronic conditions is crucial for improving healthcare outcomes.
- Variations in care delivery exist between different primary care physician (PCP) types and practice settings (rural vs. urban).
- The role of PCPs in managing pediatric chronic illnesses requires further investigation.
Purpose of the Study:
- To examine the patterns of care provided by primary physicians for children with chronic illnesses.
- To compare the practices of pediatricians and general practitioners in managing pediatric chronic conditions.
- To identify underutilized services in the management of pediatric chronic illnesses by primary care physicians.
Main Methods:
- A survey was conducted among 82 primary care physicians (pediatricians and general practitioners) in a ten-county region of Upstate New York.
- Data collected focused on the percentage of children with chronic conditions seen annually and referral patterns.
- Physician practices regarding the provision of broader aspects of care, including mental, social, and technical services, were assessed.
Main Results:
- Approximately 7.4% of children seen annually by primary care physicians have one or more chronic conditions.
- Most children with chronic conditions are referred to subspecialists, with referral frequency dependent on the disorder's nature.
- Rural physicians and general practitioners more frequently assume primary responsibility for broader aspects of care compared to urban physicians and pediatricians, respectively.
- Mental, social, and some technical services are generally underutilized by primary care physicians for children with chronic illnesses.
Conclusions:
- Primary care physicians, particularly those in rural settings and general practitioners, play a significant role in the comprehensive care of children with chronic conditions.
- Subspecialist referral is common, but the extent of primary physician involvement in broader care aspects varies.
- There is a need to enhance the utilization of mental, social, and technical services within primary care settings for pediatric chronic illness management.
Abstract:
Patterns of care provided by primary physicians for children with chronic physician illnesses are examined. Pratices of pediatricians are compared with those of general practitioners in a ten-county region in Upstate New York. Data collected from 82 physicians surveyed in nine rural counties and one urban area indicate that, on the average, 7.4% of all children seen annually have one or more chronic conditions. Most such children are referred to subspecialists for part or all of their care; the frequency of referral, however, depends chiefly on the nature of the disorder. Primary responsiblity for the broader aspects of care is more often assumed by rural than urban physicians and more often by general practitioners than pediatricians. Nevertheless, mental, social, and some technical services are generally underutilized by groups of primary physicians.