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Paediatric primary care in Europe: variation between countries
  1. Diego van Esso1,
  2. Stefano del Torso2,
  3. Adamos Hadjipanayis3,
  4. Armand Biver4,
  5. Elke Jaeger-Roman5,
  6. Bjorn Wettergren6,
  7. Alf Nicholson7,
  8. and the members of the Primary–Secondary Working Group (PSWG) of the European Academy of Paediatrics (EAP)
  1. 1Primary Care Centre ‘Pare Claret,’ Barcelona, Spain
  2. 2Pediatra di Famiglia ULSS16 Padua, Italy
  3. 3Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
  4. 4Clinique Pédiatrique, Centre Hospitalier Luxembourg, Luxembourg
  5. 5Paediatric Primary Care Office, Berlin, Germany
  6. 6Child and Adolescent Public Health, Uppsala, Sweden
  7. 7Children's University Hospital, Dublin, Ireland
  1. Correspondence to Dr Diego van Esso, CAP Pare Claret (Institut Català de la Salut), C/ Sant Antoni M Claret 19–21, E-08037 Barcelona, Spain; dvanesso{at}


Background Although it is known that differences in paediatric primary care (PPC) are found throughout Europe, little information exists as to where, how and who delivers this care. The aim of this study was to collect information on the current existing situation of PPC in Europe.

Methods A survey, in the form of a questionnaire, was distributed to the primary or secondary care delegates of 31 European countries asking for information concerning their primary paediatric care system, demographic data, professionals involved in primary care and details of their training. All of them were active paediatricians with a broad knowledge on how PPC is organised in their countries.

Results Responses were received from 29 countries. Twelve countries (41%) have a family doctor/general practitioner (GP/FD) system, seven (24%) a paediatrician-based system and 10 (35%) a combined system. The total number of paediatricians in the 29 countries is 82 078 with 33 195 (40.4%) working in primary care. In only 15 countries (51.7%), paediatric age at the primary care level is defined as 0–18 years. Training in paediatrics is 5 years or more in 20 of the 29 countries. In nine countries, training is less than 5 years. The median training time of GPs/FDs in paediatrics is 4 months (IQR 3–6), with some countries having no formal paediatric training at all. The care of adolescents and involvement in school health programmes is undertaken by different health professionals (school doctors, GPs/FDs, nurses and paediatricians) depending on the country.

Conclusions Systems and organisations of PPC in Europe are heterogeneous. The same is true for paediatric training, school healthcare involvement and adolescent care. More research is needed to study specific healthcare indicators in order to evaluate the efficacy of different systems of PPC.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.