EuropeanEuropean AcademyAcademy of of PaediatricsPaediatricsResearchResearch in in AmbulatoryAmbulatory SettingsSettings

NetworkNetwork

Stefano del Torso, Stefano del Torso, ItalyItaly (CESPER)(CESPER)ZachiZachi Grossman, Israel, (IPROS)Grossman, Israel, (IPROS)JaverJaver DiezDiez Dominguez, Spain (VIVA)Dominguez, Spain (VIVA)Andreas Gerber, Germany Andreas Gerber, Germany ( ( PediatricianPediatrician, , Professor in Health Economics, Professor in Health Economics, UniKUniKöölnln ))Alf Nicholson, IrelandAlf Nicholson, Ireland

With the collaboration of With the collaboration of Richard C. Wasserman, USA (PROS Director, AAP) Richard C. Wasserman, USA (PROS Director, AAP) Anna Anna DrabikDrabik, , StatisticianStatistician IGKE, IGKE, KKöölnln, , GermanyGermany ..

EuropeanEuropean AcademyAcademy of of PaediatricsPaediatricsResearchResearch in in AmbulatoryAmbulatory SettingsSettings NetworkNetwork

EAPRASnetEAPRASnet TASK FORCETASK FORCE

EAPRASnetEAPRASnet

DecemberDecember 2008 PSWG, EC meeting2008 PSWG, EC meetingJanuaryJanuary 2009 2009 SurveySurvey PreparationPreparation and Testand TestJanuaryJanuary Mailing List, Web PageMailing List, Web PageJanuaryJanuary RecruitmentRecruitment byby CoordinatorsCoordinatorsFebruaryFebruary SurveySurvey MailedMailed, , RemindersReminders 3 3 MarchMarch RepliesReplies checkcheck (> 300 (> 300 mailsmails) ) MarchMarch RemindersReminders Dead LineDead LineAprilApril AnalysisAnalysis, , DraftDraft

ZG, AG, AD, ZG, AG, AD, SdTSdT + + NationalNational CoordinatorsCoordinators

EAPRASnetEAPRASnetwww.eapaediatrics.eu/www.eapaediatrics.eu/eapraseapras

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

Hungary M

Greece P

Ireland FD

Germany MFrance MCzech Republic PCyprus PBulgaria FDBelgium MAustria M Israel P

Italy MLithuania MLuxembourg M

Sweden FD

Switzerland MSpain PSlovenia PSlovakia PNetherland FD

CountryCountry / / PediatricPediatric Care SystemCare System

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

PSWG 20 PSWG 20 coordinatorscoordinators agreedagreedSurveySurvey 19 19 CountriesCountries participatedparticipatedRecruitmentRecruitment 150 150 pediatricianspediatriciansParticipantsParticipants 139 139 ( 93 % )1 1 toto 14 14 pediatricianspediatricians/country ( PILOT ) /country ( PILOT )

11 11 countriescountries hadhad 100% 100% repliesreplies (> 1 p)(> 1 p)

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

Quest.PCP

110/1100/110Ireland1215901590Hungary

513001300Greece964316431Germany726142614France522932293Czech Rep7190190Cyprus115001500Bulgaria3800800Belgium1525525Austria

QuestPCP

1393279632796Total4200200Sweden

14775775Switzer.950005000Spain

10230230Slovenia710201020Slovakia62828Luxemb.1464464Lithuania

1475007500Italy13800800Israel

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

Designed by Designed by EAPRASnetEAPRASnet Task Force Task Force Prepared by IGKE, UNIKOLNPrepared by IGKE, UNIKOLNSent through the EAPRAS mailing Sent through the EAPRAS mailing listlistFilled surveys sent back as a file , Filled surveys sent back as a file , by mail as an attachment , by fax by mail as an attachment , by fax or by ordinary mail to IGKEor by ordinary mail to IGKEData Data AnalysisAnalysis byby IGKE (AD and AG)IGKE (AD and AG)PresentationPresentation byby SdTSdT and ZG.and ZG.

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

To characterize general To characterize general pediatricianspediatricians and and practice demographics like the age, gender, practice demographics like the age, gender, and time spent in patient care and practice and time spent in patient care and practice arrangement. arrangement. To provide information on number of patients To provide information on number of patients and age distribution of patients. and age distribution of patients. To learn what unsolved issues in To learn what unsolved issues in pediatricpediatricprimary care need to be studied, according to primary care need to be studied, according to the practicing the practicing pediatricianspediatricians’’ point of view.point of view.To elucidate the main incentives for To elucidate the main incentives for engagement in research activity.engagement in research activity.

Question 1: What is your Question 1: What is your age (in years)?age (in years)?

30-39 40-49 50-60 > 60

S1

14.39

26.62

46.04

12.95

0.00

10.00

20.00

30.00

40.00

50.00

AGE years

Question 2: In which country Question 2: In which country do you practice?do you practice?

7.91%11Ireland8.63%12Hungary3.60%5Greece6.47%9Germany5.04%7France3.60%5Czech R5.04%7Cyprus0.72%1Bulgaria2.16%3Belgium0.72%1Austria

100.00139Total2.88%4Sweden

10.07%14Switzerland6.47%9Spain7.19%10Slovenia5.04%7Slovakia

4.32%6Luxemb.0.72%1Lithuania10.07%14Italy9.35%13Israel

Question 3: What is your Question 3: What is your gender?gender?

Question 4: What percentage of Question 4: What percentage of your time is spent in the following your time is spent in the following areas?areas?

General Pediatrics > 50% time

5.76%5.04%

89.2%

Question 6: During a typical workweek, how Question 6: During a typical workweek, how many hours do you spend in many hours do you spend in direct patient caredirect patient care, , administration, teaching, research : administration, teaching, research :

Direct Patient Care % time

6%13%

19%60%

1%1%

< 20%

20-40%

41-60%

61-70%

> 70%

n.a.

Question 6: During a typical workweek, how Question 6: During a typical workweek, how many hours do you spend in direct patient care, many hours do you spend in direct patient care, administrationadministration, teaching, research : , teaching, research :

ADMINISTRATION % TIME

1.44%5.04%2.88%

32.37%58.27%

< 20%

20-40%

41-60%

61-70%

> 70%

n.a.

Question 7: How many practitioners Question 7: How many practitioners (including yourself) are associated with (including yourself) are associated with

this practice?this practice?

1,44%2101,44%281,44%262,16%355,04%745,04%734,32%62

23,74%33146.04%640

Nurses

Question 8: Please indicate your Question 8: Please indicate your practice arrangement.practice arrangement. ( 137/139 )( 137/139 )

47.4540.15

12.40

05

101520253035404550

Solo Practice GroupPractice

MultiSpecialtyPractice

Solo Solo PracticePractice : : OthersOthers

Secretaries 2 , Cleaning lady 1Secretaries 2 , Cleaning lady 1Administration 1Administration 1Assistant 1Assistant 1Cleaner 1Cleaner 1Employee 1Employee 1Lab workersLab workers 11Medical Secretary 1Medical Secretary 1Psychologist 1Psychologist 1SecretarySecretary 44Social assistant, Social assistant, OdontologistOdontologist 22

PE teachers, dietitian, psychologistPE teachers, dietitian, psychologist 11

Question 9: Please give an estimate Question 9: Please give an estimate of your own number of patients.of your own number of patients.

8.7621.9

36.5 32.85

0

10

20

30

40

< 500 501-1000 1001-1500 > 1500

Number of Patients

Question 10: If you can, please give an Question 10: If you can, please give an estimate of your own number of patients estimate of your own number of patients in percent by age range.in percent by age range.

% of Patients by Age Group

48.06

25.7 18.787.410

10

20

30

40

50

60

0-6 >6<10 >10<16 > 16

Mean Value

Question 11: Do you use an Question 11: Do you use an electronic medical recordelectronic medical record??

Use of Electronic Medical Record

28%

72%

No

Yes

0

5

10

15

20

25

30

35

percent

Quality of careindicators

Psychosocialproblems

(ADHD, etc.)

Communicationwith parents

Obesity Translatingguidelines into

practice

Top issues : rated Top issues : rated ““55””

Main triggers for participation Main triggers for participation in future in future EAPRASnetEAPRASnet projectsprojects

10.0714Honorarium/reimbursement for participation in research

69.7897A sense of contribution to child health research

37.4152Feeling of affiliation

73.38102Improve the quality of care in my practice

68.3595Intellectual stimulation

Main incentive for participation Main incentive for participation in a future in a future EAPRASnetEAPRASnet projectproject

19.4227Honorarium/reimburs. for participation in research

33.8147Study appears easy to do

57.5580Having enough time/energy to do it

71.2299Being convinced that study results will change practice

81.29113Interest in the topic

Main obstacles to participationMain obstacles to participation

22.3031Lack of interest in research

22.3031Lack of energy

7.1910Lack of incentives for research

24.4634Studies appear complex

34.5348Studies appear time comsuming

46.0464No interest in the proposed topics

72.66101Lack of time

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

SummarySummary 11

Practicing General Practicing General PediatriciansPediatricians 139139Male/ Female Male/ Female 50 %50 % > 50 y > 50 y 59 %59 %General General PediatricsPediatrics > 50 % time > 50 % time 89 %89 %Direct Patient Care > 60% time Direct Patient Care > 60% time 79 %79 %Administration time 20 Administration time 20 –– 40 % time 40 % time 32 %32 %Solo Practice Solo Practice 47 %47 %No Nurse /Secretary No Nurse /Secretary 46 %46 %More than 1000 patients More than 1000 patients 59 %59 %Pts.AgePts.Age < 6 y. < 6 y. 48%48% , >6 <10 y. , >6 <10 y. 26 %26 % 74 %74 %Use of Electronic Medical Record Use of Electronic Medical Record 72 %72 %

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

SummarySummary 22

Top issues interesting for research:Top issues interesting for research:–– Quality (guidelines, indicators etc.)Quality (guidelines, indicators etc.)–– Communication with parentsCommunication with parents–– Major diseases: Major diseases: ADHD,ObesityADHD,Obesity

Main trigger/incentive for Main trigger/incentive for participation:participation:–– Improve the quality of care of my Improve the quality of care of my

practicepractice–– Interest in topicInterest in topic

Main obstacleMain obstacle::–– Lack of timeLack of time

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

GOOD NEWSGOOD NEWSParticipatingParticipating countriescountries//pediatricianspediatriciansCoordinatorsCoordinators ( ( RecruitmentRecruitment , , RepliesReplies ))Time ( Time ( JanuaryJanuary –– MarchMarch 2009 ) 2009 ) VeryVery lowlow costscostsPediatriciansPediatricians interestedinterested toto participateparticipateSocietiesSocieties interestedinterested toto collaboratecollaborate

EAPRASnetEAPRASnetRecruitmentRecruitment surveysurvey

BAD NEWSBAD NEWS

Mailing, FAQ, Mailing, FAQ, ListsLists, , ChecksChecks > > SecretarySecretaryCountriesCountries / / CoordinatorsCoordinators (some) (some) EAP IT EAP IT serviceservice ( ( WebpageWebpage ))QuestionnaireQuestionnaire ( mail, fax, ( mail, fax, reg.mailreg.mail etcetc ) )

EAPRASnetEAPRASnetThe FutureThe Future

ResearchResearch TopicsTopicsWeb Site, Web Web Site, Web BasedBased QuestionnaireQuestionnaireSecretarySecretaryRecruitmentRecruitment ((CountriesCountries, , CoordinatorsCoordinators, , MembersMembers) ) CollaborationsCollaborationsFundingFunding

EAPRASnetEAPRASnetThe FutureThe Future

DVE DVE -- EAP EC EAP EC ProposalProposalRefusalRefusal toto vaccinatevaccinate

EAACI EAACI PediatricsPediatrics SectionSectionFood Food AllergyAllergy and and AnaphylaxisAnaphylaxis

COST COST HarmonizationHarmonization of of paediatricpaediatric standardsstandards in in PrimaryPrimary CareCare

EAPRASnetEAPRASnet / AAP PROS meeting: EAPS 2010/ AAP PROS meeting: EAPS 2010

ThereThere isis strengthstrength in in numbersnumbersThe The keykey isis globalglobal networkingnetworking

EAPRASnetEAPRASnetwww.eapaediatrics.eu/www.eapaediatrics.eu/eapraseapras

SteeringSteering CommitteeCommitteeChairmanChairman…………………………………………………………...SdT.SdTScientificScientific DirectorDirector…………..………………………….ZG.ZGResearchResearch ConsultantConsultant …………………………...AG.AG (AD)(AD)CoordinatorsCoordinators //ECPCPECPCP…….. FB, FK, GK, MSZ .. FB, FK, GK, MSZ PSCWG PSCWG delegatesdelegates ………………………….DVE.DVE, AH , AH

EAPRASnetEAPRASnet SC SC MeetingsMeetings at EAP at EAP meetingsmeetings

EuropeanEuropean AcademyAcademy of of PaediatricsPaediatricsResearchResearch in in AmbulatoryAmbulatory SettingsSettings

NetworkNetwork