What medical professional is the most adequate, in developed countries, to provide health care to children in primary care?: Systematic review

Abstract

Introduction: There is controversy about which health professional is the most adequate –pediatricians (PED) or family practitioners/general physicians (FP/GP)– to provide health care services to children and adolescents in Primary Care (PC). There are not previous systematic reviews approaching this subject in the previously published literature. The objective of this study is to compare health care provided between PED and FP/GP in the following aspects of the clinical practice: antibiotic (ATB) prescription; diagnostic test indication; management of acute otitis media (AOM), asthma, febrile syndrome, and several psychopathological conditions, and preventive measures accomplishment. Material and methods: Study design: Systematic review. Data sources: MEDLINE and CENTRAL databases, TRIP Database and Google Scholar, were searched until December 2008 to retrieve original papers and systematic reviews comparing the clinical practice of both kinds of health professionals. No language restriction was made. Study selection: studies of any kind of design were included (cross-sectional, cohort, case-control and experimental) comparing the clinical practice of PED and FP/GP. The references without original research were excluded (letters to the editor, editorials). The methodological quality of each study was assessed What medical professional is the most adequate, in developed countries, to provide health care to children in primary care? Systematic review Bunuel Alvarez JC, Garcia Vera Cb, Gonzalez Rodriguez Pc, Aparicio Rodrigo Md, Barroso Espadero De, Cortes Marina RBf, Cuervo Valdes JJg, Esparza Olcina MJh, Juanes de Toledo Bi, Martin Munoz Pj, Monton Alvarez JLk, Perdikidis Oliveri Ll, Ruiz-Canela Caceres Jm Pediatrician. ABS Girona-4. Girona; Pediatrician. CS Sagasta-Ruisenores. Instituto Aragones de Ciencias de la Salud (Aragonese Institute of Health Sciences). Zaragoza; Pediatrician. CS Manzanares El Real. Madrid; Pediatrician. CS Entrevias. Madrid; Pediatrician. CS Don Benito. Badajoz; Pediatrician. ABS Girona-3. Girona; Pediatrician. CS Urbano I. Merida, Badajoz; Pediatrician. CS Barcelona. Servicio Madrileno de Salud (Health Service of the Autonomous Community of Madrid). Mostoles, Madrid; Pediatrician. CS El Espinillo. Madrid; Pediatrician. Unidad de Gestion Clinica La Plata/Palmete. Sevilla; Pediatrician. CS Mar Baltico. Madrid; Pediatrician. CS Los Fresnos. Torrejon de Ardoz, Madrid; Pediatrician. Distrito Sanitario de Sevilla (Sevilla Health District). Sevilla. Spain. CS: Centro de Salud (Public Health Center of Primary Care). ABS: Areas Basicas de Salud (Basic administrative areas of the Public Health Administration in certain places in Spain). Addresses for correspondence about this article: JC Bunuel, jcbunuel@gmail.com Conflict of Interest: All the authors of this revision are members of the Grupo de Trabajo de Pediatria Basada en la Evidencia (Evindece-based Pediatrics Work Group) that belongs to the Asociacion Espanola de Pediatria de Atencion Primaria (AEPap / Primary Care Pediatrics Spanish Association) and to the Asociacion Espanola de Pediatria (AEP / Spanish Association of Pediatrics). Funding: financial resources provided by the “Pediatria y Salud” Foundation (Madrid / Spain). 3 Suplemento PAP (color)_INGLES_Q8:PAP No 27 19/10/11 18:27 Pagina 3