Preschool children as frequent attenders in primary health care in Croatia: Retrospective study

Abstract

Aim: To define predictive factors for frequent attenders among pre-school children in primary health care and investigate the association between socioeconomic factors and medical factors, as well as the reasons for child's appointment in the physician's office. Methods: This retrospective study was conducted in 7 primary health care offices (6 family physician practices and 1 pediatric practice) in Zagreb, Croatia. The study included 964 preschool children from 1-6 years who visited these practices during 2005. Children in the highest quartile of consultation frequency (n = 255) were defined as frequent attenders, while the children in the lowest quartile of consultation frequency (n = 302) represented the control group (non-frequent attenders). We collected data on consultation rate, socioeconomic factors, health care providers, prescriptions and referrals, symptoms, and diagnoses. Association of the parameters and the frequency of consultations was investigated by logistic regression analysis. Results: Frequent attenders sought for consultations 10 times per year (median, range 4-26), and they had the following characteristics: had 2-3 years, attended day care center, were treated by a pediatrician, and received more prescriptions and referrals. Their major complaints were: cough, nasal discharge, rash, fever, difficult breathing, earache, digestive problems, throat soreness, and injuries. Logistic regression analysis showed significant association between frequent attendance and age of 2-3, the symptom of nasal discharge, and diagnoses of infectious and parasitic diseases, middle ear diseases, respiratory system diseases, and skin and subcutaneous tissue diseases. Conclusion: Socioeconomic characteristics, symptoms, and diagnoses were important predictors for defining preschool frequent attenders in primary health care.