No representative data currently exist in Germany for pediatric primary healthcare (PC) needs, i.e. on the utilization of pediatric child and adolescent medical services. In December 2005 the working group on research in PC pediatrics was founded under the auspices of the German Academy for Child and Adolescent Medicine in order to advise on how such data could be acquired based on a 1-year continuous collation from pediatric PC practices. The objectives of the study were to describe the tasks of pediatricians in PC by analyzing the reasons why patients (families, children and adolescents) visited pediatric practices, which acute, chronic or social pediatric diagnoses were made and what role preventive measures had in pediatric PC. Additionally, there was interest in which cases PC pediatricians thought it necessary to refer patients to pediatric subspecialists, admit a patient to hospital and how much time was taken up by these various healthcare measures. For 1 year (from the second quarter of 2010 to the first quarter of 2011) 29 primary care pediatricians from all regions in Germany documented all presenting complaints, the corresponding diagnoses of patients and additionally documented the duration of each patient-doctor contact. Data from 54,134 patients with 193,458 doctor or practice-patient contacts could be evaluated. Slightly more than 50 % of the patients were under 6 years of age, 23 %were schoolchildren (6-10 years) and 26 % were adolescents (10-18 years). The most common acute complaints (as the primary contact in the healthcare system) were coughing, ear, nose, throat or abdominal aches and pains with or without fever as well as fever and skin problems. In 43 % of cases symptoms were caused by infectious diseases, 17 % of diagnoses could be attributed to non-infectious problems and diseases in various organ systems. In 8.1 % problems could be subsumed under the heading of the new morbidity (NM). Most referrals to pediatric sub-specialists or other specialists and most hospital admissions were made for patients with problems and diseases in the category of NM and for patients with diseases of an organ system. Preventive measures (i.e. vaccinations and preventive medical examinations) accounted for 29.3 % of all doctor-patient contacts. Together with the consultations for problems in the category of NM, doctors spent the same amount of time as for the care of all patients with acute somatic diseases. With increasing age, more and more adolescents were treated by general practitioners. This did not apply to chronically ill adolescents who were disproportionately represented in the adolescent group of 10-18 years with 25 % of patients and 40 % of visits. Children and adolescents with chronic diseases had proportionally different needs for counseling than otherwise healthy children and adolescents. As before, infectious diseases play a major role in pediatric primary healthcare; however, preventive measures, diagnosis and therapy of problems and diseases of the NM category and primary healthcare of chronically ill children and adolescents are becoming increasingly more important.
