Objective: To study the inter-consultations made with the second level by two out-patient paediatrics clinics, with regard to the reliability of the information system and the characteristics of the people referred in relation to the requested specialties.
Design: Descriptive.
Setting: Urban health centre.
Patients and other participants: All children for whom a second level opinion was sought during 1993.
Measurements and main results: An inter-consultation was requested for 493 children, with an average age of 7.5. 65% were in the 6 to 14 age group, 33.3% in the 10-14 group. 45.4 of each 100 consultations were for ophthalmology, which, together with infant traumatology, dermatology, ENT and allergy, made up 87.8% of all the inter-consultations. Broken down by specialty, the most common reasons were: defects of refraction in ophthalmology; hip disorders in nursing children and feet problems, both in traumatology; changes in nevi, resistant eczemas and skin infections, all in dermatology; relapse cases of otitis and adenoiditis in ENT; and seasonal rhinoconjunctivitis (RCJ) in allergy. The result of the referral was known in writing in 31.6% of cases. The reason for the referral was recorded in the clinical notes in 92.7% of cases.
Conclusions: The total number of referrals depends on the limit of paediatric age. By children's ages, the referrals most requested were: less than one month to cardiology, from 1 to 12 months to traumatology, from 2 to 3 years to ENT, over 9 to allergy and over 12 to ophthalmology, traumatology and endocrinology. Almost half the consultations are for ophthalmology, the main reasons being problems in refraction and the check-ups engendered by this problem. An internal channel to return information needs to be established.