Title
A novel triage approach of child preventive health assessment: An observational study of routine registry-data?
Author
Bezem, J.
Theunissen, M.
Buitendijk, E.S.
Kocken, P.L.
Publication year
2014
Abstract
Background The coverage of preventive health assessments for children is pivotal to the system of preventive health screening. A novel method of triage was introduced in the Preventive Youth Health Care (PYHC) system in the Netherlands with an associated shift of tasks of professionals. Doctor’s assistants carried out pre-assessments to identify children in need of follow-up assessment, whereas in the traditional approach all children would have been screened by a doctor or nurse. The accessibility and care delivery of this new PYHC system was studied. Methods The new triage approach was compared to the traditional approach in 780 children undergoing PYHC assessment with the use of an observational retrospective study design. Outcomes were attendance of assessment appointments (accessibility of care) and referral of children to either extra PYHC assessment or external specialised care (delivery of preventive care). PYHC registry data were analysed. In two regions of the Netherlands, 390 children five to six years of age were randomly selected from the PYHC registries according to the socio-economic strata of the schools they attended. Results When the triage and traditional approaches to PYHC were compared, we found similar attendance rates for assessment appointments, namely about 90%. As expected, 100% of the children in the traditional group were assessed by a PYHC doctor compared to 46% of the children in the triage group. Significantly fewer children were referred for extra PYHC assessment or for treatment by an external specialised care giver when a triage as opposed to the traditional assessment approach was used (19.6% vs. 45.9%). Conclusions The novel triage approaches to PYHC were compared, we found similar attendance rates for assessment appointments, namely about 90%. As expected, 100% of the children in the traditional group were assessed by a PYHC doctor compared to 46% of the children in the triage group. Significantly fewer children were referred for extra PYHC assessment or for treatment by an external specialised care giver when a triage as opposed to the traditional assessment approach was used (19.6% vs. 45.9%).
Subject
Behavioural Changes
CH - Child Health
ELSS - Earth, Life and Social Sciences
Healthy for Life
Health
Healthy Living
Triage
Task shifting
Efficient organization
Health service supply and distribution
Preventive youth health care
Preventive health assessments
Children
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http://resolver.tudelft.nl/uuid:c556659b-e8ca-4e12-87c5-2e8b99952dbe
DOI
https://doi.org/10.1186/s12913-014-0498-0
TNO identifier
519130
Source
BMC Health Services Research, 14
Article number
498
Document type
article