Exploring the potential of triage and task-shifting in preventive child health care

Bezem, J. (2017)

Doctoral Thesis

We studied a novel triage approach to the organisation of routine assessments by Preventive Child Health care (PCH), including task-shifting among professionals. In the triage approach, access to PCH, and the detection of the health problems studied, were comparable with the usual approach. The efficient deployment of PCH professionals using triage and task-shifting reduced the costs and involvement of PCH physicians and nurses in routine assessments, particularly in the youngest age group (5 to 6 years). The associated release of workforce and budgets may create more opportunities for the delivery of care to children and their families with specific health-care needs. In our study, in the triage approach PCH physicians and nurses provided more demand-driven care at the request of parents and others such as school professionals. We have emphasised the importance of making the PCH programme more flexible to create time for PCH professionals to collaborate with professionals from the school system, and from the youth care and primary care systems, with the aim of improving joint commitment to early detection, and the delivery of more coordinated care. More research is needed into the outcomes of referral to extra care and into the cost benefits of the triage approach.

• Triage
• Task-shifting
• Preventive child health care
• Preventive health assessment
• Children
• Specific needs
• School health services
• Efficient organization
• Health service supply and distribution

• All authors: Bezem, J.
• Supervisor: Numans, M.E.; Buitendijk, S.E.
• Co-supervisor: Kocken, P.M.
• Committee: Berger, M.Y.; Bont, A.A. de; Mesman, J.; Vermeiren, R.R.J.M.; Crone, M.R.
• Qualification: Doctor (dr.)
• Awarding Institution: Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2017-11-28
• ISBN (print): 9789463322508
• Sponsorship: ZonMw