Pasientgjengangere i en barnepoliklinikk - assistentlegevirksomheten

Abstract

Summary

Background Some children have medical conditions that cause frequent consultations with doctors and long-lasting care from the health service. It might be a challenge to provide continuity and a proper care for this group of patients. We studied who the frequent users of a pediatric outpatient clinic are, and the organisation of the work of the doctors with these children. We compared the follow-up of children with somatic diseases to that of children with non-specific problems or psycosomatic disorders.

Material and methods This study includes all children that had at least four consultations with a doctor other than consultants at the Pediatric Outpatient Clinic at Rikshospitalet-Radiumhospitalet (the University Hospital) from 1 June, 2000 to 31 May, 2004. Material from these children`s consultations was retrospectivly registered.

Results 297 children were included in the study. Among these, 225 had a specific physical diagnosis after the first consultation during the four years, while 72 had non-specific problems. The latter children saw fewer doctors who were not consultants than those with somatic diagnosis. In addition, fewer of these children had consultations with consultants than those with somatic diseases. The majority of those who did not have a specific diagnosis after the first consultation, got one later during the four years. 14 children were, however, given an observation diagnosis for all their consultations during the period. 28,3 % of the children in the study, were less than one year at the first consultation. About half of these were taken care of by an experienced consultant as well during the four years.

Interpretation The great majority of the frequent users of the day care unit was children with somatic diagnosis. Those with non-spesific disorders had more continuity in the care given by doctors, but fewer of these were followed-up by a specialized doctor compared to those with somatic diseases.