Chronic illness in childhood: a regional survey of care.

Patterns of care provided by primary physicians for children with chronic physician illnesses are examined. Pratices of pediatricians are compared with those of general practitioners in a ten-county region in Upstate New York. Data collected from 82 physicians surveyed in nine rural counties and one urban area indicate that, on the average, 7.4% of all children seen annually have one or more chronic conditions. Most such children are referred to subspecialists for part or all of their care; the frequency of referral, however, depends chiefly on the nature of the disorder. Primary responsiblity for the broader aspects of care is more often assumed by rural than urban physicians and more often by general practitioners than pediatricians. Nevertheless, mental, social, and some technical services are generally underutilized by groups of primary physicians.