Background and objectives: There are no contemporary data to describe which paediatric conditions general practitioners (GPs) see, which conditions they refer, and where and whether referrals differ by general practice, patient or GP factors. A better understanding of the this could inform GP training needs and workforce planning. The aim of this study was to address knowledge gaps around the case mix of general practice paediatric consultations, as well as GP referral patterns, associated factors and costs.

Method: A cross-sectional analysis of 49,932 paediatric consultations was performed across 22 general practices in Victoria and New South Wales involving 130 GPs. General practice electronic medical records were analysed to determine consultation reasons and referrals.

Results: Common reasons for visits included medical issues, immunisations, developmental-behavioural concerns, check-ups and mental health. GPs referred 10% of visits, predominantly for mental health. Referral patterns were associated with private billing, GP demographics, patient characteristics and years of working in general practice. Most referrals were to private specialists. Estimated costs to the healthcare system were $1.39 million.

Discussion: GPs mostly refer to private specialists for mental health and developmental-behavioural concerns, particularly with private billing, indicating access disparities. Increased public sector capacity for these conditions is needed. Strengthening paediatric primary care could yield significant cost savings by reducing referrals.

背景和目的： 目前没有数据描述全科医生（GPs）在儿科领域遇到的常见疾病、他们会将哪些病例转诊，以及这些转诊是否因普通诊所、患者或医生因素而有所不同。更好地理解这些问题可以为GP培训需求和劳动力规划提供信息。本研究旨在填补有关普通诊所儿科咨询组合的知识空白，同时探讨GP转诊模式、相关因素及成本。

方法： 对维多利亚州和新南威尔士州22个普通诊所的49,932次儿科咨询进行了横断面分析，涉及130名全科医生。通过分析电子医疗记录来确定就诊原因及转诊情况。

结果： 常见的就诊原因包括医学问题、疫苗接种、发育行为关注点、常规检查和心理健康问题。GPs将大约10%的病例进行转诊，其中大多数是因为心理健康问题。转诊模式与私人收费、GP的人口统计特征、患者特点及在普通诊所工作的年数有关。大多数转诊是向私人专科医生进行的。对卫生系统的估计成本为139万澳元。

讨论： GPs主要将心理健康和发育行为问题的病例转介给私人专科医生，特别是在收取私人费用的情况下，这表明存在获取医疗服务方面的不平等现象。需要增加公共部门在这类条件下的服务能力。加强儿科初级保健可以减少转诊并带来显著的成本节省。