Children and Adolescents as Patients in General Practice - The Reasons for Encounter

BACKGROUND: The SESAM 2 study was performed to estimate consultations of general practitioners. In the recent work we focused on the reasons for encounter of children and adolescents consulting the general practitioner. METHODS: Cross-sectional study with general practices in Saxony (Germany) as setting. Two hundred and seventy of the 2510 (10.8%) Saxon general practitioners agreed to participate and recorded data of 8877 patients. Evaluation of the data was organized by the Saxon Society of General Medicine (SGAM). Cross-sectional data were collected during a one-year period. One day of the week (Monday till Friday) was chosen at random for recording. Data were documented from every tenth patient with personal contact to the practitioner using a standardized report form at either the morning or afternoon consulting hours. Main outcome measures: reasons for encounter, the investigations and treatments performed and also the results of the consultation. Unpublished but publicly available data from the Dutch Transition Project were also analysed. RESULTS: Eight hundred and five of 8877 patients were aged under 20 years. The mean percentage of children and adolescents in the general practice consultation was 9.1%. The mean number of reasons for encounter per child patient was about 1.5 and did not differ between the age groups. Most consultations were due to respiratory, digestive, skin or general symptoms with typical seasonal variations regarding the most frequent reasons for encounter caused by infectious diseases. CONCLUSIONS: As there is limited access to pediatric specialists, German general practitioners have to deal with children quite frequently. The number of child reasons for encounter is manageable for the general practitioner with an increasing spectrum of reasons for encounter among adolescents. In agreement with other publications most of the young patients consult for respiratory or general symptoms, or require preventive immunization or injection. KEYWORDS: Children; Adolescents; Reason for encounter; General practice; Primary care