Role of Pediatricians in the Ambulatory Care of Children in Taiwan, 1999-2011

Chieh-Mao Chuang; I-Ching Chan; Yu-Sheng Lee; Pei-Chen Tsao; Chia-Feng Yang; Wen-Jue Soong; Tzeng-Ji Chen; Mei-Jy Jeng

doi:10.1016/j.pedneo.2014.10.004

Role of Pediatricians in the Ambulatory Care of Children in Taiwan, 1999-2011

Pediatr Neonatol. 2015 Aug;56(4):226-34. doi: 10.1016/j.pedneo.2014.10.004. Epub 2014 Nov 21.

Authors

Chieh-Mao Chuang¹, I-Ching Chan¹, Yu-Sheng Lee¹, Pei-Chen Tsao¹, Chia-Feng Yang¹, Wen-Jue Soong¹, Tzeng-Ji Chen², Mei-Jy Jeng³

Affiliations

¹ Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
² Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Electronic address: tjchen@vghtpe.gov.tw.
³ Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: mjjeng@vghtpe.gov.tw.

PMID: 25534697
DOI: 10.1016/j.pedneo.2014.10.004

Abstract

Background: Pediatricians are physicians trained to provide comprehensive nonsurgical health care for children, but parents may consult other specialists when seeking medical help for their children. This study was designed to analyze the role of pediatricians and the changes in the patterns of ambulatory visits among different specialties for children under the age of 18 years in Taiwan during the past 13 years.

Methods: Data on ambulatory visits of children aged 0-17 years from 1999 to 2011 were retrieved from the National Health Insurance Research Database. The physician's specialty, level of the hospital, year of visit, age of the patient, and diagnoses of each ambulatory visit were analyzed. Four of the most commonly visited specialties-pediatrics, otolaryngology, family medicine, and internal medicine-were compared. The yearly trend of ambulatory visits to different specialties, difference in various age groups, influence of hospital levels, and the top 10 diagnoses were analyzed.

Results: A total of 1,618,033 ambulatory visits were identified and enrolled into our study. A comparison of the proportions of ambulatory visits between 1999-2003 and 2007-2011 showed that the proportions of visits increased from 27.1 ± 1.3% to 35.4 ± 1.0% for pediatricians, decreased from 32.8 ± 1.8% to 17.0 ± 0.8% for family physicians, and did not change for otolaryngologists and internal medicine physicians. Specifically, pediatricians were visited more often if the children were younger, or if the health-care facility (level of hospital) was either a medical center or a regional hospital. Upper respiratory tract infection was the top diagnosis, followed by acute bronchitis, and acute and chronic tonsillitis.

Conclusions: The role of pediatricians in children's ambulatory care increased in importance from 1999 to 2011 in Taiwan. However, approximately two thirds of children sought ambulatory medical help from nonpediatric physicians. Thus, it is important to educate and encourage parents to visit pediatricians if their children require medical help.

Keywords: National Health Insurance Research Database; ambulatory care; children; health care; pediatrician.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Ambulatory Care / methods*
Child
Child, Preschool
Databases, Factual
Female
Humans
Infant
Infant, Newborn
Male
National Health Programs / statistics & numerical data
Pediatrics*
Physician's Role*
Taiwan