title: General practitioner provision of preventive child health care: analysis of routine consultation data.
abstract: BACKGROUND
  GPs contribute to preventive child health care in various ways, including provision of child health surveillance (CHS) reviews, opportunistic preventive care, and more intensive support to vulnerable children. The number of CHS reviews offered in Scotland was reduced from 2005. This study aimed to quantify GPs' provision of different types of preventive care to pre-school children before and after the changes to the CHS system.
  
  
  METHODS
  GP consultation rates with children aged 0-4 years were examined for the 2½ years before and after the changes to the CHS system using routinely available data from 30 practices in Scotland. Consultations for CHS reviews; other aspects of preventive care; and all reasons were considered.
  
  
  RESULTS
  Prior to the changes to the CHS system, GPs often contributed to CHS reviews at 6-8 weeks and 8-9 and 39-42 months. Following the changes, GP provision of the 6-8 week review continued but other reviews essentially ceased. Few additional consultations with pre-school children are recorded as involving other aspects of preventive care, and the changes to CHS have had no impact on this. In the 2½ years before and after the changes, consultations recorded as involving any form of preventive care accounted for 11% and 7.5% respectively of all consultations with children aged 0-4 years, with the decline due to reductions in CHS reviews.
  
  
  CONCLUSIONS
  Effective preventive care through the early years can help children secure good health and developmental outcomes. GPs are well placed to contribute to the provision of such care. Consultations focused on preventive care form a small minority of GPs' contacts with pre-school children, however, particularly since the reduction in the number of CHS reviews.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK. rachael.wood@ed.ac.uk
authors.forename: Rachael
authors.initials: R
authors.lastname: Wood
authors.forename: Philip
authors.initials: P
authors.lastname: Wilson
mesh_terms: D002657:Child Development / Q000502:physiology; D002662:Child Health Services; D002675:Child, Preschool; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010821:Physicians, Family / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011314:Preventive Health Services / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data* / Q000639:trends; D012606:Scotland; D013997:Time Factors; D014600:Utilization Review / Q000706:statistics & numerical data