Do patients of integrative anthroposophic pediatric inpatient departments differ? Comparative analysis to all pediatric inpatients in Germany considering demographic and clinical characteristics

Abstract

BackgroundIntegrative medicine (IM) is a patient-centered, evidence-based, therapeutic paradigm which combines conventional and complementary approaches. The use of IM in pediatrics has increased in the past two decades and parents’ demand for it is growing. An IM whole systems approach is anthroposophic medicine. Considering the growing demand for integrative approaches in children, it is relevant from a public health perspective to find out which kind of children use IM in Germany and whether they differ from the entirety of pediatric inpatients in Germany. Moreover, it would be interesting to known, whether these patients are willing to travel a longer distance to gain integrative treatment.MethodsThe present study investigates the standard ward documentation datasets of 29,956 patients of all German integrative anthroposophic pediatric inpatient wards from 2005 to 2016 and compares them systematically to collect data of the entirety of all pediatric inpatient wards in Germany. Apart from patients’ age and gender, and the ICD-10 admission diagnoses, the geographical catchment area of the hospitals were analyzed.ResultsSociodemographic characteristics of pediatric inpatients in the integrative anthroposophic departments (IAH) did not differ from the entirety of all pediatric inpatients. Regarding clinical characteristics, higher frequencies were found for endocrine, nutritional and metabolic diseases (IAH: 7.24% vs. 2.98%); mental, behavioral, and neurodevelopmental disorders (IAH: 9.83% vs. 3.78%) and nervous diseases (IAH: 8.82% vs. 5.16%) and lower frequencies for general pediatric diseases such as respiratory diseases (IAH: 17.06% vs. 19.83%), digestive diseases (IAH: 3.90% vs. 6.25%), and infectious and parasitic diseases (IAH: 12.88% vs. 14.82%) in comparison to the entirety of all pediatric inpatients in Germany. The IAH showed a broad catchment area, with most patients being from former, Western federal republic of Germany. Large catchment areas (> 100 km) for the IAH are merely covered by severe and chronic diseases.ConclusionPediatric inpatients of IAH do not differ from the entirety of pediatric inpatients in Germany regarding sociodemographic characteristics but show differences regarding clinical characteristics. Parents are willing to travel further distance to get specialized integrative anthroposophic medical care for children with severe and chronic diseases.

Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

“…This result pattern is known from a previous study of our working group on the patient characteristics and clinical characteristics of integrative anthroposophic pediatric departments in Germany [43]. Furthermore, this result is in line with other international studies that conclude that the use of integrative medicine seems to be more frequent in in children with severe and chronic diseases [7,16,[30][31][32][33][34][35][36].…”

“…Diagnosis and treatment in both hospitals are in accordance with official pediatric guidelines from scientific societies and furthermore include treatment options from Anthroposophic Medicine [ 40 , 55 ]. This anthroposophic treatment includes [ 43 ]: complementary pharmacotherapy, medicinal baths, rhythmical massages, compresses, and embrocation (rhythmic massages with etheric oils [ 38 ]), as well as art therapy, eurythmy, speech therapies, music therapy [ 39 ], and light/ color therapy [ 56 ]. Both hospitals are part of the German regular medical care and thus funded by the statutory health insurers.…”

“…The GKH practices diabetology, oncology, neonatology, rheumatology, psychosomatics and neurology in children alongside general pediatrics. The staff include physicians, nursing staff, pharmacists and therapists who are all trained in integrative medicine [43].…”

“…There are two anthroposophic hospitals in Germany that offer integrative treatment for children in distinct pediatric departments: The Gemeinschaftskrankenhaus Herdecke (community hospital) near Dortmund and the Filderklinik in Filderstadt near Stuttgart [23,42]. A recent study of our working group found a large catchment area for these hospitals all over Germany and that parents are willing to travel further distance to get specialized integrative anthroposophic medical care for children with severe and chronic diseases [43].…”