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Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization

Crocker, Joanna C., Evans, Meirion Rhys, Powell, Colin Victor Eric, Hood, Kerenza and Butler, Christopher Collett 2013. Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization. European Journal of General Practice 19 (4) , pp. 213-220. 10.3109/13814788.2013.795538

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BACKGROUND: Early consultation in primary care may provide an opportunity for early intervention in children developing pneumonia, but little is known about why some children do not consult a general practitioner (GP) before hospitalization. OBJECTIVES: To identify differences between children who consulted a GP and children who did not consult a GP before the day of hospital presentation with pneumonia or empyema. METHODS: Carers of children aged six months to 16 years presenting to hospital with pneumonia or empyema completed a questionnaire, with a subset participating in an interview to identify physical, organizational and psychological barriers to consultation. Responses from those who had consulted a GP before the day of hospital presentation were compared with those who had not on a range of medical, social and environmental variables. RESULTS: Fifty seven (38%) of 151 participants had not consulted a GP before the day of hospital presentation. On multivariate analysis, illness duration ≥ 3 days (odds ratio [OR] 4.36, 95% confidence interval [CI]: 1.67-11.39), prior antibiotic use (OR: 10.35, 95% CI: 2.16-49.55) and home ownership (OR: 3.17, 95% CI: 1.07-9.37) were significantly associated with early GP consultation (P < 0.05). Interviews with 28 carers whose children had not seen a GP before the day of presentation revealed that most had not considered it and/or did not think their child's initial symptoms were serious or unusual; 11 (39.3%) had considered consulting a GP but reported barriers to access. CONCLUSION: Lack of early GP consultation was strongly associated with rapid evolution of pneumonia.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Adolescent, Child, Child, Preschool, Empyema, Female, General Practitioners, Health Services Accessibility, Hospitalization, Humans, Infant, Male, Multivariate Analysis, Pneumonia, Primary Health Care, Questionnaires, Referral.
Publisher: Informa Healthcare
ISSN: 1381-4788
Last Modified: 30 Jun 2017 03:38

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