title: Changing morbidity patterns in children in Dutch general practice: 1987-2001.
abstract: OBJECTIVE
  To examine the presentation and pattern of childhood morbidity in general practice compared with 14 years ago.
  
  
  METHODS
  We used data of all children aged 0-17 years from two cross-sectional surveys performed in 1987 and 2001 in general practice in the Netherlands. The total number of children in the practices participating in these surveys were 86,577 children in 1987 and 82,053 children in 2001. First of all, we compared consultation rates of children in general practice. Secondly, childhood morbidity was assessed by episodes of disease, coded according to the International Classification of Primary Care (ICPC). We compared childhood morbidity in 1987 and 2001 by assessing the distribution of episodes among ICPC chapters stratified by ethnicity, and by comparing incidence rates of most frequently presented diseases.
  
  
  RESULTS
  Childhood consultation rates have decreased from 2.7 visits a year per child in 1987 to 2.1 in 2001. The distribution of episodes among ICPC chapters had also changed. Respiratory problems are still the most frequently presented health problem in children but the proportion has decreased from 25.5% in 1987 to 23.3% in 2001. Skin problems were presented more often (23.0% in 2001 versus 17.8 in 1987), and Western children more often presented with skin problems than with respiratory problems in 2001. Incidence rates of most respiratory diseases have decreased and specific skin diseases (dermatomycosis, impetigo and eczema) were diagnosed more often.
  
  
  CONCLUSIONS
  In the Netherlands, childhood morbidity has changed. Skin diseases have become more important in general practice and respiratory problems are declining.
authors.affiliation: Department of General Practice, Erasmus University Medical Center, Rotterdam, Netherlands.
authors.forename: Hanneke B M
authors.initials: HB
authors.lastname: Otters
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.forename: François G
authors.initials: FG
authors.lastname: Schellevis
authors.forename: Lisette W A
authors.initials: LW
authors.lastname: van Suijlekom-Smit
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity / Q000639:trends*; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors