Autori: Giorgio L. Colombo, Marta Vinci, Mauro Caruggi
To evaluate the different prescribing conducts in between Paediatrics (PED) and General Practitioners (MMG) in the diagnosis and in the care of streptococcal pharyngotonsillitis in paediatric age and to estimate the costs of this pathology.
This is an observational retrospective study developed with the cooperation of a sample of doctors, stratified on the base of the resident people distribution. It had been requested to the PED and MMG involved to fill in a survey for each of the last 10 treated younger then 15 years old, affected by pharyngotonsillitis and observed in a sequential way in between December 2002 and February 2003.
50 PED and 120 MMG distributed on the whole national territory.
A sample of 701 patients (52 PED vs. 249 MMG) with an average age of 8,2 years old has been enrolled. The total medical cost of an episode of streptococcal pharyngotonsillitis has resulted to be € 17,59, during a one month observation. In the group of patients enrolled by MMG the total medical cost was of € 20,31 vs. € 16,09 of patients enrolled by PED. Such differences have to be imputed mainly to the greater cost of the prescribed antibiotic therapy (€14,60 of MMG group vs. €7,70 of PED group). The therapies with penicillin have resulted more prescribed by PED (20,1% vs. 8,8% of MMG p<0,000). It’s been confirmed a greater resort to effect the diagnostic test by PED compared to MMG (29,3%). Also it’s been noticed a different articulation of the resources consumption and the treatment of these patients between those enrolled by MMG and those enrolled by PED.
The analysis of the different diagnostic and therapeutic conducts shows the necessity of further examinations concerning the receptivity by doctors of the international recommendations and of their effective role of impact in the decisional processes and in the therapies choices.
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