20 Preventive health care of infants and preschool children in primary health care practices in croatia in 2018

Abstract

<h3>Objective</h3> To present prevention activities in primary health care of infants and preschool children in Croatia during 2018, based on data from Central Health Information System of the Republic of Croatia (CEZIH). <h3>Methods</h3> Health care of infants (up to one year of age) and preschool children (1-6 years of age) is in Croatia provided within the pre-school children’s health service and the family (general) medicine service. More than 90% of children is in care of primary pediatricians and the rest of them in the care of general practitioners. Practices which are contracted by Croatian Health Insurance Fund routinely send electronic messages with information about the patient and individual visit through CEZIH. As of 2018, Croatian Institute of Public Health also has partial access to those data, for the purpose of analyzing preventive and curative work of primary health care services. In this paper, based on CEZIH data, preventive visits of infants and preschool children in both pre-school children’s health service and family (general) medicine service in 2018 are analyzed. The term ‘preventive visit’ refers to any contact with primary health-care providers: visit, examination, telephone counselling and other contacts for preventive procedures. Each of these procedures has its own code in the list of diagnostic and therapeutic procedures. <h3>Results</h3> During 2018, total number of health care users aged 0 to 6 was 272,043, with 2,611,939 visits. Among them, there were 37,619 infants with 533,880 visits, an average of 14.2 visits per infant, while preschool children had an average of 8.9 visits. Among the total visits, 504,469 preventive visits were recorded (19.3% of all visits), of which 327,637 were examinations, and 176,832 were counselling sessions. Out of total number of preventive examinations, there were 281,029 check-up examinations (85.8%), of which 166,240 in infants (4.4 per infant) and 114,789 in preschool children (0.5 examinations per child). During preventive visits, a total of 107,483 referrals were issued (17.6% of all issued referrals), of which 57.3% for infants. Most referrals from preventive visits of infants were for diagnostic purposes (40.1%), and from preventive visits of preschool children for the examination by consultant physician (52.2%). <h3>Conclusion</h3> According to CEZIH data, preventive activities account for a fifth of the total activities in children´s health care on a primary level. The plan and program of health care measures sets four check-up examinations in infants, which, according to CEZIH data, has been achieved. However, in the period after the first year of life, three systematic examinations per preschool child were not performed or data on this were not recorded in the CEZIH. On average, every fifth preventive visit results in the discovery of a pathological condition due to which the infant or young child is referred for further treatment. Monitoring the growth and development of children by conducting regular check-up examinations is an important measure in the prevention and early detection of developmental disorders and the preservation of children´s health.