Well-being of children with chronic illness. A population-based study in a Swedish primary care district

According to a previous study, 8% of all children in Dalby primary care district were chronically ill. The impact of the illness on the children's well-being was investigated using parental questionnaires. No difference in socio-demographic variables was found between responders (70%) and non-responders. The study comprised 98 index and 168 control children. Comfort and well-being in school and pre-school were lower among the index than among the control children and lower among the index children in normal compared with special schools. According to the parents many teachers had insufficient knowledge of disorders/handicaps. Children with a physical disability more often had special remedial education compared with healthy children. The chronically ill children were bullied more often, had fewer contacts with peers and more emotional problems than the control group. Improved knowledge of chronic childhood disorders/disabilities and recognition of the psychosocial consequences at school/pre-school and in the child health services is advocated

Utilization of primary care versus specialized care in children with and without chronic illness. A population-based study

Children's utilization of curative care was studied to analyse the division of responsibilities between undifferentiated primary care and specialized care. All chronically ill (n = 510), a control group (n = 287) and the total population 0-15 years of age (n = 6080) in a primary care district were studied using register data. Chronically ill children comprised 8.4% of the total child population and were registered for 1/10 of the primary health care visits, 1/3 of the specialized visits, 1/3 of the hospitalizations and 1/2 of the in-patient days of all children. The yearly ambulatory visits were 3.7/child in the chronically ill and 1.5/child in the control group, of which 1/3 and 2/3, respectively, were to primary care. Utilization of specialized care increased with disability. Chronically ill children visited primary care mainly for acute respiratory infections but seldom for allergic or other chronic conditions