Background and aims In Italy and throughout the world, increasing importance is being given to primary care with a noticeable shift of interest towards the "territory" and the need to re-think global paediatric assistance.
Methods On the basis of F.I.M.P.-FVG data, we examined the organisation and critical points of primary paediatric care, currently identified in Italy with Family paediatrics.
Results FVG is a region with 1,200,000 inhabitants, 124 family paediatricians (pdf) and an average number of 938 patients/pdf. These are organised as single pdf (74), in association (29), in group practices (21). Critical points: new sanitary duties (i.e. high percentage of immigrants with social integration difficulties, complex psychological problems, necessity to cover some second level services especially concerning the management of children affected by chronic pathologies, etc.), difficulty to maintain the traditional relationship of doctor/patient trust in large groups of pdf practices, progressive reduction in numbers of pdf whose average age is around 55.
Conclusions The broadening of paediatric primary care requires a re-definition of the "mission" of the doctors working in the area not only regarding duties of care, but also of training and scientific research, with special attention to identifying the new assistance needs. Furthermore, when faced with duties of ever-increasing responsibility, the current organisation could prove to be insufficient and the nurse will have to take on an increasingly important role with a larger number of duties taken over. The number of nurses should probably be al least 1 nurse for every 400 children.
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