[Challenges in pediatric primary prevention in childhood].
In the Federal Republic of Germany the regulations for primary care in community paediatrics are not uniform in the different German states. Some states have reduced their services for community paediatrics dramatically. Such reductions in primary care for children appeal to many German states, who almost all face major deficits in the state budget. Such reductions will be a threat to child health in Germany unless these services are offered from other non-state agencies. This is not the case. Three examples of deficits in paediatric primary care are given and the potential role of community paediatrics to compensate is discussed. The examples given relate to injury prevention, vaccination and child abuse. Parent counselling regarding age-specific injury risks for infants and toddlers is not systematically offered in Germany. The vaccination coverage for measles e.g. is only 80% and below allowing for some 5 to 10 annual deaths from measles encephalopathy in Germany. Although primary care physicians in Germany are competent to recognize child neglect and abuse therapy is often hampered by the absence of a network of coordinated therapeutic facilities. These examples constitute a challenge to community paediatrics in Germany.
von Kries
R
R
Ludwig-Maximilians-Universität, Abt. Pädiatrische Epidemiologie, München.
von Voss
H
H
D002648:Child; D003363:Cost Control / Q000639:trends; D005544:Forecasting; D005858:Germany; D006801:Humans; D009313:National Health Programs / Q000191:economics*; D010348:Patient Care Team / Q000191:economics; D010372:Pediatrics / Q000191:economics*; D011320:Primary Health Care / Q000191:economics; D011322:Primary Prevention / Q000191:economics*; D014611:Vaccination / Q000191:economics
Herausforderungen in der kinderärztlichen Primärprävention im Kindesalter.