[Current situation of the demand for health care in neuropaediatrics. Characteristics of consultations and comparison with other paediatric specialties]

Rev Neurol. 2014 Nov 1;59(9):392-8.
[Article in Spanish]

Abstract

Introduction: In recent years it seems we are witnessing an increasing demand for neuropaediatric care. Epidemiological studies are needed to make this demand more widely known and thus promote appropriate management of health care resources.

Aims: To determine what proportion of all visits to the paediatric department in our hospital are neuropaediatric consultations, the annual consultation rate in child neurology per 1,000 inhabitants under 14 years of age, and the characteristics of that consultation (demographic data, reasons for the visit and others).

Patients and methods: We conducted a retrospective, descriptive study on the health care activity of paediatric and neuropaediatric units in a level-II public hospital in the south of Madrid, over the period 2008-2012.

Results: Since our centre opened, the number of paediatric consultations has increased sharply, neuropaediatric visits being the most frequently demanded. In the year 2012 a total of 2,129 patients were seen (718 first visits), with a successive/first visit index of 1.96. Of all the paediatric consultations carried out in the hospital, 23.49% took place in neuropaediatrics. The mean rate of first visits in the period under study was 72.86/1,000 children. The main reasons for the consultation were learning disabilities/conduct disorders (24.1%), followed by headaches (21.9%), paroxysmal episodes (14.8%) and delayed psychomotor development (9%).

Conclusions: The increase in demand for neuropaediatrics health care was clearly higher than that of other paediatric specialities over the same period of time. In the five years included in the study, the rate of first visits increased threefold. This health care overload could condition the care dispensed to patients with severe neurological pathologies. Further studies of a similar nature in different regions are required to determine the real situation of neuropaediatrics in Spain.

Title: Situacion actual de la demanda asistencial en neuropediatria. Caracteristicas de la consulta y comparacion con otras especialidades pediatricas.

Introduccion. En los ultimos años parecemos asistir a una creciente demanda asistencial en neuropediatria. Los estudios epidemiologicos son necesarios para dar a conocer dicha demanda y asi favorecer una adecuada gestion de los recursos sanitarios. Objetivo. Conocer el peso proporcional de las consultas de neuropediatria en el global de las consultas pediatricas en nuestro hospital, la tasa anual de consulta en neurologia infantil por cada 1.000 habitantes menores de 14 años y las caracteristicas de dicha consulta (datos demograficos, motivos de consulta y otras). Pacientes y metodos. Estudio retrospectivo, descriptivo, sobre la actividad asistencial de consultas pediatricas y neuropediatricas en un hospital publico de nivel II en el sur de Madrid, durante el periodo 2008-2012. Resultados. Desde la apertura de nuestro centro, las consultas de pediatria han experimentado un marcado crecimiento, siendo las de neuropediatria las mas demandadas, ya que en el año 2012 atendieron a un total de 2.129 pacientes (718 primeras consultas), con un indice de sucesiva/primera consulta de 1,96. En neuropediatria, se atendieron el 23,49% de todas las consultas pediatricas realizadas en el hospital. La tasa media de primeras consultas en el periodo de estudio fue de 72,86/1.000 niños. Los principales motivos de consulta fueron los problemas de aprendizaje/trastornos de conducta (24,1%), seguidos de cefalea (21,9%), episodios paroxisticos (14,8%) y retraso del desarrollo psicomotor (9%). Conclusiones. El incremento en la demanda asistencial de la neuropediatria ha resultado claramente superior al de las otras especialidades pediatricas que llevan en funcionamiento el mismo periodo. En los cinco años de estudio, la tasa de primeras visitas se ha triplicado. Esta sobrecarga asistencial podria condicionar la atencion a los pacientes con patologia neurologica grave. Serian necesarios estudios similares en diferentes regiones para conocer la realidad de la neuropediatria española.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Developmental Disabilities / epidemiology
  • Headache / epidemiology
  • Health Services Needs and Demand / trends*
  • Hospital Departments / statistics & numerical data*
  • Hospitals, University / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data*
  • Humans
  • Learning Disabilities / epidemiology
  • Medicine
  • Movement Disorders / epidemiology
  • Nervous System Diseases / epidemiology
  • Neurology / statistics & numerical data*
  • Pediatrics / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Spain
  • Tertiary Care Centers / statistics & numerical data*