Are child health surveillance reviews just routine examinations of normal children?

摘要

BACKGROUND: The provision and content of child health surveillance (CHS) has changed greatly since 1990. However, its value continues to be questioned. The introduction of the personal child health record (PCHR) has provided a new means of collecting data about CHS. AIM: To identify what problems are recorded at CHS reviews in the PCHR during the first year of life, and what follow-up/referrals result directly from these reviews. METHOD: A total of 28 practices were recruited from one health authority. All babies born to mothers registered with study practices during one year were followed up. Health visitors returned copies of CHS reviews recorded in children's PCHRs. Written comments on returned reviews were analysed. RESULTS: In all, 2308 babies were entered into the study and 2001 (87%) were followed up for one year. A total of 7848 (78%) CHS reviews were returned. Physical problems were recorded in 58% of children at the 10-14 day, 35% at the six to eight week, and 39% at the six to nine month review. Of physical problems recorded at CHS reviews, 30% required follow-up in primary care and 7% required referral to hospital. Other problems were recorded less frequently and health promotion was recorded at only 7.5% of CHS reviews. CONCLUSION: Child health surveillance provides important opportunities to discuss problems that may cause parental concern and to identify children requiring treatment or follow-up. The design and use of the PCHR needs to change to reflect increasing emphasis on health promotion.