With the ageing of the population, children's health tends to become a neglected area in health research and health care research. And this is unjustified, considering that the children of today are tomorrow's adults and that their health is originated in childhood. Measurement of child's health over time will identify the emergence of new childhood health problems and morbidity trends. The recognition of such trends may lead to a shift in priorities in child health care. The aims of this thesis are to present an overview of children's morbidity in Dutch general practice and general practitioners' management, and to evaluate changes therein over the past decades. Moreover, determinants of morbidity or changes in general practitioners' management are assessed in order to provide tools for prevention of morbidity or for the improvement of clinical practice. To investigate these issues, data of 0-17 year old children of two successive national surveys in Dutch general practice were used (1987-2001). Both surveys were designed and performed by the Netherlands Institute for Health Service Research (NIVEL). In both surveys, general practitioners registered all contacts with patients during the study period. Among others, they recorded the diagnosis and if a referral or prescription was made, this was linked to the corresponding diagnosis. Characteristics of the practices and study population were obtained by mailed questionnaire, and the response rate was 70-90% dependant on different variables.

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Erasmus University Rotterdam
B.W. Koes (Bart)
hdl.handle.net/1765/51701
Erasmus MC: University Medical Center Rotterdam

Rijkels-Otters, H. (2004, December 15). Childhood morbidity in Dutch general practice : epidemiology and management. Retrieved from http://hdl.handle.net/1765/51701