Being aware of reason for visit is particularly important, especially in the high risky age groups, such as children, because it reflects the patients’ concern that necessitated a visit [1]. If health workers and policy makers want to make themselves ready for better qualities of care and plan about health priorities, so identifying the prevalence of diseases would be a necessary task. Awareness of reasons for visits in an ambulatory and outpatient clinic is different with those referred to emergency departments.
This descriptive study has been done on all children under 5 years old, referring to the community-oriented teaching pediatric clinic of Kermanshah, Iran, within 10 years July 2002- Feb 2011. In this study all outpatient clients' information such as time of referring, age, gender and complaints of patients based on their own words if possible. Based on age our target community was divided into 4 groups including: neonates<15 days, neonates >15 days, infants 1-12 months, and 13 months-5 years old. Data was analyzed by SPSS-16.
Our target population included (N=11941) 6004 girls and 5822 boys and 115 cases not mentioned. Based on age, they were included neonates <15 days (N=428), neonates >15 days (N=275), 1-12 months (N=4008), 13month-5 years (N=7230). The 10 leading primary medical reasons of referring in all of our clients (N=11941) were as follows: insufficient growth (N=2844, 23.8%), cough (N=1387, 11.6%), fever (N=1329, 11.1%), nasal discharge (N=1318, 11%), diarrhea (N=735, 6.2%), agitation (N=456, 3.8%), loss of appetite (N=353, 3%), sore throat (N=349, 2.9%), belly ache (N=326, 2.7%) and vomiting (N=244, 2%). Respectively, these 10 leading reasons of references represent about 78.2% of primary medical enrollee visits. Our research showed that 10 leading reasons of primary medical references in total of references were not the same in each of our age groups and it was different. In terms of year most references were for the year 2002, and least references were for year 2006, and in terms of season, most references were in spring, fall, summer and winter respectively.
Our statistic data showed that the 10 leading medical reasons of references in all clients was different based on gender (p=0.0001), and age (p=0.0001) respectively. But in studies fever has been the most prevalent reason of referring to the centers [2], in the current study fever with the frequency of 11.1% of the primary medical references, although it was in the third rank among the most common reasons of references, but this prevalence was less than the same studies. Insufficient nutrition and inferior respiratory tract infections has always caused various problems in children of developing countries [3]. With regard to “insufficient growth” as the most complaint in our clients, we are concerned to improve well-being and health in this group of age.
References
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1.
Adekoya N. Reasons for visits to emergency departments for Medicaid and State Children's Health Insurance Program patients: United States, 2004. N C Med J. 2010;71(2):123-30. [PubMed ID: 20552761].
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2.
Goldman RD, Scolnik D. Underdosing of acetaminophen by parents and emergency department utilization. Pediatr Emerg Care. 2004;20(2):89-93. https://doi.org/10.1097/01.pec.0000113877.10140.d2.
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3.
Roth DE, Caulfield LE, Ezzati M, Black RE. Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions. Bull World Health Organ. 2008;86(5):356-64. [PubMed ID: 18545738].