Chronic Illness in Childhood: A Regional Survey of Care

Abstract

Patterns of care provided by primary physicians for children with chronic physical illnesses are examined. Practices of pediatricians are compared with those of general practitioners in a 10-county region in Upstate New York [USA]. Data collected from 82 physicians surveyed in 9 rural counties and 1 urban area indicate that, on the average, 7.4% of all children seen annually have 1 or more chronic conditions. Most such children are referred to subspecialists for part or all of their care; the frequency of referral depends chiefly on the nature of the disorder. Primary responsibility for the broader aspects of care is more often assumed by rural than urban physicians and more often by general practitioners than pediatricians. Mental health, social and some technical services are generally underutilized by both groups of primary physicians.