Adolescents and ambulatory care services: results from a national survey among young people 15 to 20 years old in Switzerland.

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.