Paediatric outpatient care: socio-demographics and healthproblems

Abstract

The general paediatric outpatient care in the university hospitals in the Netherlands provides secondary and tertiary care to children aged from 0 to 16 years. Since several years, the patient population and the use of healthcare appears to be changing and these developments require further analyses. Outpatient departments as well as emergency departments are visited by children with different ethnic and socio-economic backgrounds with a diversity of health problems. The first aim of this thesis was to obtain insights into patient characteristics, especially ethnicity and socio-economic status, and medical problems presented to the emergency department and the outpatient department of a university paediatric hospital. Clinicians suggest changes in healthcare use by parents and patients. They perceive an increase of non-urgent visits to emergency departments and an increase of second opinion visits at outpatient departments. Therefore, the second aim was to evaluate non-urgent visits and second opinion visits in paediatric outpatient care. The third aim was to obtain and delineate possible explanations for differences in health and helpseeking behaviour between ethnic minorities Insight into these aspects of paediatric outpatient care (healthproblems, healthcare use and patient characteristics), can be helpful in the development of strategies that might optimise and fine tune the care for groups of children with different backgrounds and health problem