title: Physician consultation in young children with recurrent pain-a population-based study.
abstract: Background. Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods. The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3-10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, socio-economic status (SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain. Results. Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and mental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions. Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.
authors.affiliation: Faculty of Business Management and Social Sciences, University of Applied Sciences Osnabrück , Osnabrück , Germany ; German Paediatric Pain Centre, Children's Hospital Datteln , Germany.
authors.forename: G
authors.initials: G
authors.lastname: Hirschfeld
authors.affiliation: German Paediatric Pain Centre, Children's Hospital Datteln , Germany ; Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University , Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wager
authors.affiliation: German Paediatric Pain Centre, Children's Hospital Datteln , Germany ; Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University , Germany.
authors.forename: B
authors.initials: B
authors.lastname: Zernikow
keywords: Children and adolescents; Chronic pain; Health care utilization; Sequential sampling