F. Narring et Pa. Michaud, Adolescents and ambulatory care services: results from a national survey among young people 15 to 20 years old in Switzerland., ARCH PED, 7(1), 2000, pp. 25-33
In industrialized countries, statistics on health services exhibit a low le
vel of health care use by adolescents, despite the fact that their needs ha
ve been widely described.
Objectives. - To assess ambulatory health care use by 15-20-year-old teenag
ers in Switzerland.
Method. - Nine thousand, two hundred and sixty-eight adolescents responded
to the self-administered questionnaire distributed in secondary schools and
vocational classes for the Swiss Adolescent Health Survey Questions about
visits to general practitioners, specialists and gynecologists, reasons for
visit, the availability of a regular health care provider and a confidenti
al health care resource were analysed.
Results. - Within the previous 12 months, 87.6% of the girls and 75.3% of t
he boys reported having seen a physician. General practitioners were visite
d more frequently than specialists. The contact with a specialist was the o
nly one to be related to socio-demographic variables: a lower proportion of
reported visits to a specialist was related to apprenticeship, low educati
onal status of parents or rural living area. Thirty-nine percent of the gir
ls reported having seen a gynecologist during the previous 12 months. Two a
dolescents out of three reported having a personal doctor, and one out of t
wo declared being aware of a confidential health care resource. Girls repor
ted a larger number of reasons for visits than boys: chronic conditions, fa
tigue, headache and depressive symptoms were the most often cited in a list
of ten reasons. Among the subjects who declared a health concern (sleep di
sturbances, eating disorders, depressive symptoms, smoking or alcohol-relat
ed problems) and a need for help, less than 10% declared having seen a heal
th care provider for this reason, even ii more than 70% reported contact wi
th a physician within the last 12 months.
Conclusion. - These results show that most adolescents, especially girls, r
eported recent use of medical services, but did not discuss their health co
ncerns with the doctor. Training should be improved to give better knowledg
e and counseling skills to health professionals, in order to allow them to
address adolescents' health needs. (C) 2000 Editions scientifiques et medic
ales Elsevier SAS.