Is healthy children surveillance being duplicated by family physicians and paediatricians? A cross-sectional study in Portugal

OBJECTIVES To determine if children attend the family physician (FP) or the FP/paediatrician for their surveillance medical appointments, as well as analyse the variables associated with the parents' choice between the two physicians. DESIGN Cross-sectional study. SETTING Public, semiprivate and private kindergartens in the city of Vila Nova de Famalicão (Portugal). PARTICIPANTS Parents of children aged 6 years or less without chronic diseases, enrolled in the selected kindergartens. MAIN OUTCOME MEASURES Proportion of children attending the FP or FP/paediatrician for their surveillance appointments; association between the chosen physician and sociodemographic and household variables (parents' age, educational level, professional situation and marital status; household net income; number of children; the child's age; presence of private health insurance), assessment of the parents' perception of clinical knowledge and accessibility regarding the FP and the paediatrician. RESULTS A total of 697 children were included in the analysis: 30.6% attended only the FP and 69.4% attended both the FP and the paediatrician. Using a Poisson regression, the mother's age (PR=1.02, 95% CI 1.00 to 1.03), higher educational level (prevalence ratio (PR=1.15, 95% CI 1.00 to 1.33), private health insurance (PR=1.30, 95% CI 1.15 to 1.46), number of children (PR=0.86, 95% CI 0.78 to 0.94) and the child's age (PR=0.95, 95% CI 0.91 to 0.98) were statistically associated with attending both the FP and the paediatrician; parents of children who attended only FP rated the FP with a higher accessibility and knowledge mean score than those who consulted both physicians (2.91vs2.38, P<0.001, and 4.11vs3.85, P<0.001). CONCLUSIONS Our data show that 70% of our sample simultaneously attended an FP and a paediatrician. FPs are equally qualified to provide medical care to healthy children but this information is not properly transmitted to the general population.