Background

Primary health care is the foundation of a health system and has a strong influence on the efficiency of the health system as a whole. For children in Europe, it is defined by 3 primary health care models: pediatric; mixed pediatrician and family physician; and family physician. There is much debate in Europe about which model is most appropriate for children. The Lithuanian model is mixed, although health policy is geared towards the promotion of family physicians, with a decline in the number of primary pediatricians in clinical practice. Objectives: To review the children's primary health care system in Lithuania, compare the indicators of primary care by family physicians and pediatricians in Lithuania, and identify parents’ perceptions of the primary health care model for children.

Methods

A retrospective longitudinal study was performed of children’s primary health care indicators for quantity and quality in 2014-2018. A representative opinion survey of 1000 adult respondents was conducted.

Results

A total of 3.5 million children’s visits to primary care physicians (6,7±3 visits for each child) were registered in Lithuania in 2018. During a recent 5-year period (2014-2018), the number of visits did not change significantly. Visits to pediatricians accounted for 41% of all children’s visits to primary care physicians in 2018. Visits to Emergency Departments increased by 20%. The results of the survey showed that 72.3% of the respondents would prefer their children be treated by a primary care pediatrician.

Conclusion

The mixed pediatrician and family physician health care model gives parents the right to choose. The results showed a decreased number of pediatricians in primary care; pediatric primary care is more frequent than family physician care; and parents tend to trust pediatricians more. The study also showed differences in the models of service used and patterns between regions in Lithuania.