Inanspruchnahme medizinischer Leistungen

Abstract

The use of operations, visits to doctors and early diagnostic tests for children are examples of different services selected from the whole spectrum of preventative and therapeutic health service provisions in childhood and adolescence. In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which is representative for Germany, 17,641 children and adolescents aged 0-17 or their parents were questioned on subjects such as their use of medical services. The use made of individual early diagnostic tests for children remains above the 90 % limit until the U7 test and drops to 89.0 % at U8, falling to 86.4 % at U9. 81 % of children took part in all the early diagnostic tests provided until age 6 (U3 to U9). Another 16 % only took advantage of some parts of this service and 3 % of the children never went to one of these check-ups. As was to be expected, the annual rate of visits to paediatricians drops as children get older from 95.1 % for 0-2-year-olds to 25.4 % of the 14-17-year-olds, while the rate of visits to general practitioners rises from 11.8 % to 53.1 %. If one tracks the rate of visits to specialist doctors all the way across childhood and adolescence, different paths emerge: while children aged 3-6 most often visit the ear, nose and throat doctor, at primary school age they mainly see opticians, and 14-17-year-olds most often visit doctors of internal medicine, dermatologists and surgeons. 37.1 % of the 0-17-year-old children and adolescents had undergone an operation. In order of declining frequency, the operations named were adenoidectomy (15.2 %), tonsillectomy (5.9 %), herniotomy (3.6 %) and appendectomy (2.4 %). Circumcisions had been carried out on 10.9 % of the boys. The different way medical services are used in different subgroups may not only depend on medical factors but also on social factors, medical attitudes and the availability of services provided.

The influence of migratory background and parental education on health care utilisation of children

“…Again, kindergarten visit seems to have a positive influence on the timely and adequate identification and treatment of complaints like visual or hearing acuity and kinetic or cognitive development. Generally, our study results on IPERE and IIU by children from the included districts in NRW are in line with previous findings from the national KiGGS study [5,11] and with outcomes of the analyses of Koller and Mielck on school district level [6]. The prevalence rate of IPERE in children with migratory background in the current study was comparable with the prevalence rate observed in the KiGGS study for children with parents having both a migratory background [14].…”

“…Although it may be assumed that public social security systems, as they exist in Germany, ensure universal access to health care services, inequalities have been described in countries with well-developed social security systems [1,5,8,10,11,18,19]. For example, the participation rate in regular health check-up examinations during childhood which are nationally recommended in Germany and covered by the health insurance has shown to be up to 20 % lower in families with a low socio-economic status compared to families with a high socio-economic status [5,10]. On the other hand, the immunisation status of children was less likely to be complete in families with a high socio-economic status [10,11,19], which might be attributed to increased scepticism about the usefulness of vaccinations in this population sub-group [9].…”

“…and Examination Study of Children and Adolescents (KiGGS) [5,11] or the European KIDSCREEN study [1]. In addition, children's health care utilisation can be analysed with data from regular school-entry screening programmes, which are routinely conducted in most parts of Germany.…”

“…By using NRW school-entry screening data, we aimed to analyse children's health care utilisation. We intended to verify the results from the analysis of Koller and Mielck [6] and the national population-based KiGGS study [5,11] regarding the influence of migratory background and social status on participation in early recognition examinations and immunisation uptake during childhood. Furthermore, we aimed to go beyond these studies by analysing the relationship between migratory background and educational level of the families and the identification of new diagnoses during school-entry screening, which might indicate a lack of previous health care utilisation.…”

Qualität und Inanspruchnahme von Kindervorsorgeuntersuchungen in Deutschland

“…Das ging aus einem Vergleich mit der KiGGS-Studienpopulation (Basiserhebung) als auch der Bevölke-rungsstruktur der Stadt Leipzig hervor [24,25]. Die Inanspruchnahme der LIFE-Child-Studienpopulation lag im gesamten Verlauf über der KiGGS-Kurve [8]. Obwohl die untere Sozialschicht in der LIFE-Child-Population unterrepräsentiert war, reichte ihr Einfluss, um die Inanspruchnahme der anderen Sozialschichten insgesamt zu reduzieren.…”