Why do children under 5 years go to the GP in Lambeth: a cross-sectional study

Abstract

Objectives: This study identifies the most common recorded reason for attendance to primary care for children under five-years-old, including a breakdown via age, ethnicity, deprivation quintile and sex. Design: Cross-sectional Setting: 39 of 40 General Practices in Lambeth, London, UK. Participants: 22,189 children under 5 years who had attended primary care between the 1st April 2017 to 31st March 2020 and had not opted out of anonymous data sharing within Lambeth DataNet. Outcome measure: The primary objective was to identify the most frequently recorded complaint in general practice for children under five years old. The secondary objective was to understand how presenting complaint differs by age, ethnicity, sex and deprivation level. The third objective was to create a multivariate logistic regression with frequent attendance as the outcome variable. Results: Nine conditions formed over 50% of all patient interactions: the most common reason was Upper Respiratory Tract Infections (14%), followed by eczema (8%) and cough (7%). Whilst there was some variation by ethnicity and age, these nine conditions remained dominant. Children living in the most deprived area are more likely to be frequent attenders than children living in the least deprived area [AOR 1.25 (95% CI 1.12-1.39). Children of Indian [AOR 1.47 (1.04-2.08)], Bangladeshi [AOR 2.70 (1.95-3.74)], and Other White [AOR 1.18 (1.04-1.34)] ethnicities were more likely to be frequent attenders, compared to those of White British ethnicity. Conclusions: Most reasons for attendance for children under 5 years to primary care are for acute, self-limiting conditions. Some of these could potentially be managed by increasing access to community care services, such as pharmacies. By focusing on the influence of the broader determinants of health as to why particular groups are more likely to attend, health promotion efforts have the opportunity to reduce barriers to healthcare and improve outcomes.