Use of health care services by children in the first 2 years of life in The Netherlands

OBJECTIVE: To assess consumption of medical care for infants and toddlers provided by general practitioners and specialists, and of hospital admissions for young children. DESIGN: Descriptive. SETTING: Dutch Child Health Clinics (CHC). METHOD: An aselect cohort of newborns of 1988/89 of the Social Medical Survey of children attending Child health Clinics (SMOCC) were followed for two years; at maximally 8 CHC visits data were collected on the preceding interval. RESULTS: Health problems as observed in the CHCs like hearing disorders, strabismus, congenital hip dysplasia and growth disturbances were present as a cause for consultation of a GP or specialist in one out of six. Over 95% of the children went to consult their GP, 30% to a paediatrician, 20% to another specialist. Twelve per cent of the children was admitted to hospital, 10% of these more than once. Accidents caused 10% of all visits to a doctor in primary or secondary health care. Children with any form of disability at the age of two (6%) made use of the health care system as indicated in this study about three times more frequently than the non-disabled children. CONCLUSION: Nearly every child under two visited a GP, many a specialist. Timely recognition of specific health problems at the CHC prevents delay in treatment, and limits the harm in development as well as the costs.