[Pediatric consultations at the second-opinion level].

OBJECTIVE

To study the inter-consultations made with the second level by two out-patient paediatrics clinics, with regard to the reliability of the information system and the characteristics of the people referred in relation to the requested specialties.

DESIGN

Descriptive.

SETTING

Urban health centre.

PATIENTS AND OTHER

PARTICIPANTS

All children for whom a second level opinion was sought during 1993.

MEASUREMENTS AND MAIN

RESULTS

An inter-consultation was requested for 493 children, with an average age of 7.5. 65% were in the 6 to 14 age group, 33.3% in the 10-14 group. 45.4 of each 100 consultations were for ophthalmology, which, together with infant traumatology, dermatology, ENT and allergy, made up 87.8% of all the inter-consultations. Broken down by specialty, the most common reasons were: defects of refraction in ophthalmology; hip disorders in nursing children and feet problems, both in traumatology; changes in nevi, resistant eczemas and skin infections, all in dermatology; relapse cases of otitis and adenoiditis in ENT; and seasonal rhinoconjunctivitis (RCJ) in allergy. The result of the referral was known in writing in 31.6% of cases. The reason for the referral was recorded in the clinical notes in 92.7% of cases.

CONCLUSIONS

The total number of referrals depends on the limit of paediatric age. By children's ages, the referrals most requested were: less than one month to cardiology, from 1 to 12 months to traumatology, from 2 to 3 years to ENT, over 9 to allergy and over 12 to ophthalmology, traumatology and endocrinology. Almost half the consultations are for ophthalmology, the main reasons being problems in refraction and the check-ups engendered by this problem. An internal channel to return information needs to be established.