Visits to Pediatric Clinics by Adult Patients: A Nationwide Survey in Taiwan

Kang-Lung Lee, An-Min Lynn, Tzeng-Ji Chen, Ling-Yu Yang and Shu-Chiung Chiang
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Kang-Lung Lee: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan
An-Min Lynn: Master of Public Health Degree Program, College of Public Health, National Taiwan University, No. 17, Xuzhou Road, Taipei 100, Taiwan
Tzeng-Ji Chen: School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
Ling-Yu Yang: School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
Shu-Chiung Chiang: Institute of Hospital and Health Care Administration, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan

IJERPH, 2018, vol. 15, issue 7, 1-11

Abstract: Pediatricians are trained to provide non-surgical medical care to children. Improvements in medical treatments and surgical techniques have extended the survival of children with congenital diseases and chronic illnesses. Consequently, pediatricians may provide continuous medical service to their patients into adulthood. Meanwhile, as Taiwan’s birth rate has fallen to one of the lowest in the world, pediatricians are encountering growing competition. As a source of continued revenue, pediatricians could also provide medical care to adults with common diseases and patients with adult-onset chronic diseases. The aim of this study was to investigate the pattern of adult ambulatory visits to pediatric clinics recorded by Taiwan’s National Health Insurance (NHI) system during 2000 to 2011. From 1/500 sampling datasets, we found that adult ambulatory visits to pediatric clinics rose steadily and statistically significantly from 16% of total visits to pediatric clinics in 2000 to 32% in 2011. Analysis of the diagnoses associated with adult ambulatory visits to pediatric clinics indicated that the most common diagnoses for such patients at academic medical centers were chronic illnesses, including epilepsy, cardiac and circulatory congenital anomalies, and diabetes. Meanwhile, at physician clinics, airway infections/diseases and gastroenteritis were the most common diagnoses. In an era of low birth rates, our findings contribute to an evidence-based discussion and provide new information that may assist in healthcare policymaking.

Keywords: pediatrics; national health insurance; ambulatory visits; adults (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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