What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review
Introduction: There is controversy about which health professional is the most adequate -pediatricians (PED) or family practitioners/general physicians (FP/GP)- to provide health care services to children and adolescents in Primary Care (PC). There are not previous systematic reviews approaching this subject in the previously published literature. The objective of this study is to compare health care provided between PED and FP/GP in the following aspects of the clinical practice: antibiotic (ATB) prescription; diagnostic test indication; management of acute otitis media (AOM), asthma, febrile syndrome, and several psychopathological conditions, and preventive measures accomplishment. Material and methods: Study design: Systematic review. Data sources: MEDLINE and CENTRAL databases, TRIP Database and Google Scholar, were searched until December 2008 to retrieve original papers and systematic reviews comparing the clinical practice of both kinds of health professionals. No language restriction was made. Study selection: studies of any kind of design were included (cross-sectional, cohort, case-control and experimental) comparing the clinical practice of PED and FP/GP. The references without original research were excluded (letters to the editor, editorials). The methodological quality of each study was assessed with the tool "OSTEBA; Critical Appraisal Cards". Two reviewers assessed the quality of the studies independently, achieving consensus in case of discrepancy. Seven pairs of reviewers made the data extraction independently. Discrepancies were achieved by consensus. Results: On average, FP/GP prescribed more ATB than PED in upper respiratory tract infections of probable viral etiology -odds ratio (OR): 1.4; 95% confidence interval (95% CI): 1.1-1.8-; PED were more likely to adhere to clinical guidelines recommendations on febrile syndrome management (OR: 9; 95% CI: 3-25) and on attention deficit disorder with/without hyperactivity (OR: 5; 95% CI: 3-11), and showed more resolution capacity on other highly prevalent conditions in children and adolescents (such as asthma and AOM). PED showed higher vaccination coverage than FP/GP in all the studies assessing this result. Conclusion: Based on the presented results, it seems reasonable to recommend maintaining the PED figure in PC health centers and reinforcing its specific role as the first point of contact of the child with the health care system.
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Asociación Española de Pediatría de Atención Primaria
2011
|
Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322011000500001 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S1139-76322011000500001 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S1139-763220110005000012011-12-27What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic reviewBuñuel Álvarez,J.C.García Vera,C.González Rodríguez,P.Aparicio Rodrigo,M.Barroso Espadero,D.Cortés Marina,R.B.Cuervo Valdés,J.J.Esparza Olcina,M.J.Juanes de Toledo,B.Martín Muñoz,P.Montón Álvarez,J.L.Perdikidis Oliveri,L.Ruiz-Canela Cáceres,J. Pediatrics Family practice Physicians Family Interprofessional relations Primary Health Care Introduction: There is controversy about which health professional is the most adequate -pediatricians (PED) or family practitioners/general physicians (FP/GP)- to provide health care services to children and adolescents in Primary Care (PC). There are not previous systematic reviews approaching this subject in the previously published literature. The objective of this study is to compare health care provided between PED and FP/GP in the following aspects of the clinical practice: antibiotic (ATB) prescription; diagnostic test indication; management of acute otitis media (AOM), asthma, febrile syndrome, and several psychopathological conditions, and preventive measures accomplishment. Material and methods: Study design: Systematic review. Data sources: MEDLINE and CENTRAL databases, TRIP Database and Google Scholar, were searched until December 2008 to retrieve original papers and systematic reviews comparing the clinical practice of both kinds of health professionals. No language restriction was made. Study selection: studies of any kind of design were included (cross-sectional, cohort, case-control and experimental) comparing the clinical practice of PED and FP/GP. The references without original research were excluded (letters to the editor, editorials). The methodological quality of each study was assessed with the tool "OSTEBA; Critical Appraisal Cards". Two reviewers assessed the quality of the studies independently, achieving consensus in case of discrepancy. Seven pairs of reviewers made the data extraction independently. Discrepancies were achieved by consensus. Results: On average, FP/GP prescribed more ATB than PED in upper respiratory tract infections of probable viral etiology -odds ratio (OR): 1.4; 95% confidence interval (95% CI): 1.1-1.8-; PED were more likely to adhere to clinical guidelines recommendations on febrile syndrome management (OR: 9; 95% CI: 3-25) and on attention deficit disorder with/without hyperactivity (OR: 5; 95% CI: 3-11), and showed more resolution capacity on other highly prevalent conditions in children and adolescents (such as asthma and AOM). PED showed higher vaccination coverage than FP/GP in all the studies assessing this result. Conclusion: Based on the presented results, it seems reasonable to recommend maintaining the PED figure in PC health centers and reinforcing its specific role as the first point of contact of the child with the health care system.Asociación Española de Pediatría de Atención PrimariaPediatría Atención Primaria v.13 suppl.21 20112011-12-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322011000500001en |
institution |
SCIELO |
collection |
OJS |
country |
España |
countrycode |
ES |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-es |
tag |
revista |
region |
Europa del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Buñuel Álvarez,J.C. García Vera,C. González Rodríguez,P. Aparicio Rodrigo,M. Barroso Espadero,D. Cortés Marina,R.B. Cuervo Valdés,J.J. Esparza Olcina,M.J. Juanes de Toledo,B. Martín Muñoz,P. Montón Álvarez,J.L. Perdikidis Oliveri,L. Ruiz-Canela Cáceres,J. |
spellingShingle |
Buñuel Álvarez,J.C. García Vera,C. González Rodríguez,P. Aparicio Rodrigo,M. Barroso Espadero,D. Cortés Marina,R.B. Cuervo Valdés,J.J. Esparza Olcina,M.J. Juanes de Toledo,B. Martín Muñoz,P. Montón Álvarez,J.L. Perdikidis Oliveri,L. Ruiz-Canela Cáceres,J. What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
author_facet |
Buñuel Álvarez,J.C. García Vera,C. González Rodríguez,P. Aparicio Rodrigo,M. Barroso Espadero,D. Cortés Marina,R.B. Cuervo Valdés,J.J. Esparza Olcina,M.J. Juanes de Toledo,B. Martín Muñoz,P. Montón Álvarez,J.L. Perdikidis Oliveri,L. Ruiz-Canela Cáceres,J. |
author_sort |
Buñuel Álvarez,J.C. |
title |
What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
title_short |
What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
title_full |
What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
title_fullStr |
What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
title_full_unstemmed |
What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review |
title_sort |
what medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: systematic review |
description |
Introduction: There is controversy about which health professional is the most adequate -pediatricians (PED) or family practitioners/general physicians (FP/GP)- to provide health care services to children and adolescents in Primary Care (PC). There are not previous systematic reviews approaching this subject in the previously published literature. The objective of this study is to compare health care provided between PED and FP/GP in the following aspects of the clinical practice: antibiotic (ATB) prescription; diagnostic test indication; management of acute otitis media (AOM), asthma, febrile syndrome, and several psychopathological conditions, and preventive measures accomplishment. Material and methods: Study design: Systematic review. Data sources: MEDLINE and CENTRAL databases, TRIP Database and Google Scholar, were searched until December 2008 to retrieve original papers and systematic reviews comparing the clinical practice of both kinds of health professionals. No language restriction was made. Study selection: studies of any kind of design were included (cross-sectional, cohort, case-control and experimental) comparing the clinical practice of PED and FP/GP. The references without original research were excluded (letters to the editor, editorials). The methodological quality of each study was assessed with the tool "OSTEBA; Critical Appraisal Cards". Two reviewers assessed the quality of the studies independently, achieving consensus in case of discrepancy. Seven pairs of reviewers made the data extraction independently. Discrepancies were achieved by consensus. Results: On average, FP/GP prescribed more ATB than PED in upper respiratory tract infections of probable viral etiology -odds ratio (OR): 1.4; 95% confidence interval (95% CI): 1.1-1.8-; PED were more likely to adhere to clinical guidelines recommendations on febrile syndrome management (OR: 9; 95% CI: 3-25) and on attention deficit disorder with/without hyperactivity (OR: 5; 95% CI: 3-11), and showed more resolution capacity on other highly prevalent conditions in children and adolescents (such as asthma and AOM). PED showed higher vaccination coverage than FP/GP in all the studies assessing this result. Conclusion: Based on the presented results, it seems reasonable to recommend maintaining the PED figure in PC health centers and reinforcing its specific role as the first point of contact of the child with the health care system. |
publisher |
Asociación Española de Pediatría de Atención Primaria |
publishDate |
2011 |
url |
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322011000500001 |
work_keys_str_mv |
AT bunuelalvarezjc whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT garciaverac whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT gonzalezrodriguezp whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT apariciorodrigom whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT barrosoespaderod whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT cortesmarinarb whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT cuervovaldesjj whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT esparzaolcinamj whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT juanesdetoledob whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT martinmunozp whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT montonalvarezjl whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT perdikidisoliveril whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview AT ruizcanelacaceresj whatmedicalprofessionalisthemostadequateindevelopedcountriestoprovidehealthcaretochildreninprimarycaresystematicreview |
_version_ |
1755940271680389120 |