Prevalence and management of symptom diagnoses in children in general practice

全科医疗中儿童症状诊断的患病率和管理

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Abstract

OBJECTIVE: To explore the prevalence of symptom diagnoses in children in general practice and the management strategies performed by GPs. DESIGN: Retrospective cohort study. SETTING: The Netherlands. PARTICIPANTS: Participant data registered in a Dutch practice-based primary care research network (Family Medicine Network [FaMe-Net]). MAIN OUTCOME MEASURES: All episodes of care with at least 1 contact for a symptom diagnosis in 2018 as well as management strategies within each episode of care including the number and type of diagnostic interventions, therapeutic interventions, and referrals. RESULTS: Overall, 6162 children under 15 years of age and registered with GP practices were included in the cohort. Among them, 2767 (44.9%) had at least 1 contact with their GP for at least 1 symptom diagnosis, and 161 (2.6%) had at least 1 persistent symptom diagnosis. Constipation, wheezing, and weakness were the most commonly found persistent symptoms. For persistent symptom diagnoses, GPs indicated more therapeutic interventions (n=217, 40.1%) compared to diagnostic interventions (n=175, 32.3%) or referrals (n=149, 27.6%). CONCLUSION: Symptom diagnoses are highly prevalent in children in general practice. Future research should focus on which children are at risk of developing persistent symptom diagnoses and how to manage them.

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