{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:29:11Z","timestamp":1740162551947,"version":"3.37.3"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,12]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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\u2019 choice between the two physicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Public, semiprivate and private kindergartens in the city of Vila Nova de Famalic\u00e3o (Portugal).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Parents of children aged 6 years or less without chronic diseases, enrolled in the selected kindergartens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Proportion of children attending the FP or FP\/paediatrician for their surveillance appointments; association between the chosen physician and sociodemographic and household variables (parents\u2019 age, educational level, professional situation and marital status; household net income; number of children; the child\u2019s age; presence of private health insurance), assessment of the parents\u2019 perception of clinical knowledge and accessibility regarding the FP and the paediatrician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2019s age (PR=1.02, 95%\u2009CI 1.00 to 1.03), higher educational level (prevalence ratio (PR=1.15, 95%\u2009CI 1.00 to 1.33), private health insurance (PR=1.30, 95%\u2009CI 1.15 to 1.46), number of children (PR=0.86, 95%\u2009CI 0.78 to 0.94) and the child\u2019s age (PR=0.95, 95%\u2009CI 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&lt;0.001, and 4.11vs3.85, P&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-015902","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T11:10:14Z","timestamp":1519902614000},"page":"e015902","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Is healthy children surveillance being duplicated by family physicians and paediatricians? A cross-sectional study in Portugal"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-245X","authenticated-orcid":false,"given":"Susana","family":"Rebelo","sequence":"first","affiliation":[]},{"given":"Sofia","family":"Velho Rua","sequence":"additional","affiliation":[]},{"given":"Joana","family":"d\u2019Orey Le\u00e7a","sequence":"additional","affiliation":[]},{"given":"Ana","family":"Couto","sequence":"additional","affiliation":[]},{"given":"Rute","family":"Teixeira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-633X","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Firmino-Machado","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"2024051613213876000_8.3.e015902.1","unstructured":"Phillips RL , Dodoo MS , McCann JL , et al . Report to the Task Force on the Care of Children by Family Physicians. Washington, DC: The Robert Graham Center for Policy Studies in Family Medicine and Primary Care in collaboration with the American Academy of Pediatrics Center for Child Health Research, 2005."},{"key":"2024051613213876000_8.3.e015902.2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2012.02.110203"},{"key":"2024051613213876000_8.3.e015902.3","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1689"},{"key":"2024051613213876000_8.3.e015902.4","unstructured":"Jakubowski E , Busse R . Health Care Systems in the EU: a comparative study. Luxemburg: European Parliament, 1998."},{"key":"2024051613213876000_8.3.e015902.5","first-page":"1","article-title":"Portugal. Health system review","volume":"13","author":"Barros","year":"2011","journal-title":"Health Syst Transit"},{"key":"2024051613213876000_8.3.e015902.6","unstructured":"Dire\u00e7\u00e3o Geral de Sa\u00fade. Programa Nacional de Sa\u00fade Infantil e Juvenil. Portugal, Lis- bon: Dire\u00e7\u00e3o Geral de Sa\u00fade, 2013."},{"key":"2024051613213876000_8.3.e015902.7","unstructured":"Dire\u00e7\u00e3o Geral de Sa\u00fade. Programa Nacional de Vacina\u00e7\u00e3o 2017. Portugal, Lisbon: Dire\u00e7\u00e3o Geral de Sa\u00fade, 2017."},{"key":"2024051613213876000_8.3.e015902.8","unstructured":"Minist\u00e9rio da Sa\u00fade. Di\u00e1rio da Rep\u00fablica, 1.a s\u00e9rie, N.o 36 \u2014 20 de fevereiro de, 2015."},{"key":"2024051613213876000_8.3.e015902.9","unstructured":"Entidade Reguladora da Sa\u00fade. Caracteriza\u00e7\u00e3o do Acesso dos Utentes a Cuidados de Sa\u00fade Infantil e Juvenil e de Pediatria: Mar\u00e7o, 2011."},{"key":"2024051613213876000_8.3.e015902.10","unstructured":"SIARS platform. P01.02.02.R01. Relat\u00f3rio de Indicadores ACeS no Per\u00edodo em an\u00e1lise. (accessed 3 jul 2017)."},{"key":"2024051613213876000_8.3.e015902.11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/pch\/6.6.341","article-title":"Doctor shopping before and after a visit to a paediatric emergency department","volume":"6","author":"Macpherson","year":"2001","journal-title":"Paediatr Child Health"},{"key":"2024051613213876000_8.3.e015902.12","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"2024051613213876000_8.3.e015902.13","unstructured":"Andersen R , Davidson P . Improving access to care in America: individual and contextual indicators. In: Andersen RM , Rice TH , Kominski EF , eds. Changing the U.S. health care system: key issues in health services, policy, and management. San Francisco, CA: Jossey-Bass, 2001:3\u201330."},{"key":"2024051613213876000_8.3.e015902.14","doi-asserted-by":"crossref","first-page":"4141","DOI":"10.12659\/MSM.902639","article-title":"Factors determining parents' decisions to bring their children to the pediatric emergency department for a minor illness","volume":"23","author":"Burokien\u0117","year":"2017","journal-title":"Med Sci Monit"},{"key":"2024051613213876000_8.3.e015902.15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.5001\/omj.2015.68","article-title":"Sociodemographic and clinical determinants of time to care-seeking among febrile children under-five in North-Central Nigeria","volume":"30","author":"Abdulkadir","year":"2015","journal-title":"Oman Med J"},{"key":"2024051613213876000_8.3.e015902.16","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsh024"},{"key":"2024051613213876000_8.3.e015902.17","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1542\/peds.113.S5.1899","article-title":"The national survey of early childhood health","volume":"113","author":"Blumberg","year":"2004","journal-title":"Pediatrics"},{"key":"2024051613213876000_8.3.e015902.18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ajme.2016.02.005","article-title":"A cross-sectional survey of parental care-seeking behavior for febrile illness among under-five children in Nigeria","volume":"53","author":"Abdulkadir","year":"2017","journal-title":"Alexandria Journal of Medicine"},{"key":"2024051613213876000_8.3.e015902.19","unstructured":"Gabinete de Estrat\u00e9gia e Planeamento. Carta Social. Resposta Social: Creche \u2013 Equipamentos existentes no Distrito de Braga, Concelho de Vila Nova de Famalic\u00e3o. http:\/\/www.cartasocial.pt\/resultados_pesquisageral.php?filtrar=hidden&cod_distrito=03&cod_concelho=12&cod_freguesia=0&cod_area=11&cod_valencia=1103&nome=&localpostal=&temCert=false (accessed 5 Sep 2015)."},{"key":"2024051613213876000_8.3.e015902.20","unstructured":"Dire\u00e7\u00e3o Geral de Estat\u00edsticas da Educa\u00e7\u00e3o e Ci\u00eancia. Regi\u00f5es em N\u00fameros 2013\/2014, Volume I: Norte. Posrtugal, Lisbon, 2015:197\u2013200."},{"key":"2024051613213876000_8.3.e015902.21","unstructured":"C\u00e2mara Municipal de Vila Nova de Famalic\u00e3o. Jardins-de-inf\u00e2ncia. http:\/\/www.cm-vnfamalicao.pt\/_jardins_de_infancia_2 (accessed 5 Sep 2015)."},{"key":"2024051613213876000_8.3.e015902.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00409.x"},{"key":"2024051613213876000_8.3.e015902.23","first-page":"105","article-title":"Primary care physicians and specialists as personal physicians. Health care expenditures and mortality experience","volume":"47","author":"Franks","year":"1998","journal-title":"The Journal of Family Practice"},{"key":"2024051613213876000_8.3.e015902.24","first-page":"33","article-title":"Medicare costs in urban areas and the supply of primary care physicians","volume":"43","author":"Mark","year":"1996","journal-title":"The Journal of Family Practice"},{"key":"2024051613213876000_8.3.e015902.25","first-page":"608","article-title":"Is family care associated with reduced health care expenditures?","volume":"48","author":"Doescher","year":"1999","journal-title":"The Journal of Famiy Practice"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-015902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T20:26:52Z","timestamp":1715891212000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-015902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,3,1]]},"published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1136\/bmjopen-2017-015902"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-015902","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}