Trends in the utilization of outpatient medical care in childhood and adolescence. Results of the KiGGS study - a comparison of baseline and first follow up (KiGGS Wave 1)

This article provides information on trends in the utilization of outpatient medical care in childhood and adolescence in Germany on the basis of data from two waves of the KiGGS study (prevalences and odds ratios). In the period 2009-2012, 91.9 % (95 % CI 91.1-92.7 %) of children and adolescents used outpatient medical services at least once a year. In the 12 months prior to the interview, 67.9 % (95 % CI 65.9-69.8 %) of the 0- to 17-year-olds consulted a pediatrician and 34.1 % (95 % CI 31.6-36.3 %) a general practitioner. Whereas there was no change in the use of either overall outpatient or general practice medical care compared to 2003-2006, a significant increase of 8.7 % points in the utilization of pediatricians was found. This could be explained by, among other factors, an expansion of pediatric services (additional vaccinations and health screening examinations) in recent years. It may also be related to a significantly greater participation in the health screening program in early childhood (U3-U9 examinations), which was seen especially when comparing the youngest birth cohorts and in children from families with low social status (from U7 onwards). The increased use of health screening examinations can probably be attributed to the invitation, reminding and reporting procedures that have been introduced in recent years. Whereas at KiGGS baseline urban-rural differences in participation in health screening examinations could be seen, these were no longer apparent in KiGGS Wave 1. Similarly, differences between rural and urban regions in the use of general and pediatric medical services have also diminished. Nevertheless, currently children and young people in rural areas use outpatient general medical care to a greater extent than those in urban areas.