Organization of children’s primary health care: the evaluation of parents’ opinion

Aim of the study. To evaluate parents’ opinion about children’s primary health care provided by the general practitioner and a pediatrician. Methods. During September - October, 2008, a survey of parents and other persons, who were visiting general practitioner and a pediatrician with their children, was carried out in one policlinic of Kaunas. 600 questionnaires were distributed and 509 were filled-in and returned (response rate 82.8%). Results. The majority (56.0%) of the respondents favorably evaluated children’s primary health care in the policlinic. The majority of the respondents expressed satisfaction with the work of both their children’s physician and the nurse working with the doctor (56.0% and 54.8% respectively). Moreover, almost all respondents expressed confidence with their child’s doctor, more than half of the respondents have not changed their doctor since their first registration and were not inclined to do it in future. In addition, respondents had a favorable opinion about the information provided by the doctor concerning their children’s health and the quality of the preventive checks. Besides, they were satisfied with the communication between the doctor and their children. However, the respondents saw drawbacks in excessive patient’s waiting time (registration time and the waiting time in the doctor’s waiting room). Lack of information concerning the questions of children’s disease prevention and healthy lifestyle was identified by the respondents. Also dissatisfaction with the environment of the policlinic was expressed. Opinion about children’s primary health care provided by the pediatrician and by the general practitioner was evaluated. Respondents attending the pediatrician evaluated some aspects of health care better than the respondents attending the general practitioner. When a problem occured, more of the respondents got a consultation of the pediatrician on the same day, whereas, to be consulted by the general practitioner respondents had to wait for two or three days. Besides, the respondents spent less time in the pediatrician’s waiting room than the respondents in the general practitioner’s waiting room. Moreover, the pediatrician, while comparing with the general practitioner, devoted more time to a consultation, more often visited children at home, gave consultations on the phone at any time of the day. The quality of the preventive checks provided by the pediatrician was evaluated better than that by the general practitioner. The pediatrician provided parents with more information concerning their children’s health than the general practitioner. However, the nurse working with the general practitioner provided more information than the one working with the pediatrician. Besides, the general practitioner more often than the pediatrician independently diagnosed and cured eye and ear diseases and examined the spine. While analyzing the relations between various factors and the respondents’ opinion concerning children’s health care, it was estimated that the respondents’ opinion is connected with the following factors: service accessibility and acceptability, functional service quality and medical care. The better the respondents evaluated these factors, the more of them are of a favorable opinion about their children’s health care in a particular clinic. Conclusions. Majority of the respondents has been satisfied with the children’s primary health care. The respondents visiting the pediatrician have been more satisfied than the respondents visiting the general practitioner. The respondents’ favorable opinion has been related to the service accessibility and functional service quality factors as well as with biomedical factors