The following is a summary of “The role of area level social deprivation on childhood and adolescent consultation rate in primary care: a population-based, cohort study” published in the October 2022 issue of Primary Care by Fonderson et al.
Studies show that children and teens in the most socially deprived areas (SDA) see their general practitioner (GP) more often than those in the least socially deprived areas (Non-SDA). Since GPs see a wide range of diseases, it is important to know which clinical diagnoses are affected by socioeconomic factors. The main goal was to find out if there was a link between the level of social deprivation in an area and the number of consultations in a group of children. The second goal was to look into this link for a wide variety of clinical diagnoses. The Rijnmond Primary Care Database (RPCD) was used to do a cohort study. Between 2013 and 2020, 69,861 patients ages 0 to 17 who were registered with a general practitioner (GP) were looked at. The International Classification of Primary Care (ICPC-1) code was used to define a consultation as a meeting with a patient and entering a diagnosis. A Poisson regression model was used to look for links between consultation rates, ICPC-1 codes, and social deprivation at the area level. Finally, it was said what the incidence risk ratio (IRR) was and what the 95% CI was.
During the 7 years of the study, people in the study population went to the doctor 3.8 times per person-year. The 5 of the most common reasons for kids and teens to see their doctor were skin, respiratory, general, musculoskeletal, and digestive symptoms or diagnoses. The number of consultations was higher in the SDA group than in the other group (IRR 1.20, 95% CI 1.19–1.20). In the SDA group, the rate of consultations for ICPC-1 codes related to pregnancy and family planning was much lower than in the non-SDA group. After looking into this code more, the SDA group was less likely to see a doctor for oral contraception and more likely to see a doctor for an induced abortion than the Non-SDA group (IRR 0.36; 95% CI 0.33–0.44 for oral contraception and IRR 2.94; 95% CI 1.58–5.46 for induced abortion).
Overall, the SDA group was more likely to see a doctor for most clinical diagnoses, except for pregnancy and planning a family. However, in this last group, teenage girls in SDA were less likely to ask for oral contraception. This study shows how important it is to understand the reasons why children and teens seek health care at different stages of their lives.