Correspondence (letter to the editor): Non Sequitur

It is important to determine the take-up and results of the adolescent health check-up (KiGGS survey data). The conclusions drawn by the authors do not follow.

The take-up of the J1 depends on:

• How often adolescent patients present to their doctors. According to studies by statutory health insurers, 12–14 year old girls, for example, visit their doctor an average of 1.3 times a year. If during the winter months they contract an acute infection and the J1 is mentioned, this recommendation quickly pales into oblivion.

• Parental attitudes

  On the one hand, I see in my practice adolescents with the “best risks,” that is, healthy children from intact families with good integration at school and in a social context. These patients are often known to the practice. Abnormal findings are rare. On the other hand, other problems exist whose further discussion might take place within the context of the J1 (migraine, asthma, etc). Those who really need such screening examinations are not interested. This includes adolescents from dysfunctional family backgrounds with extreme media consumption; experience with alcohol, nicotine, or drugs; early sexual activity; known existing comorbidities such as obesity and its sequelae; or poorly controlled conditions such as asthma and eczema. Among the data the authors analyzed, adolescents with known obesity or nicotine misuse problems, for example, were underrepresented.

• Billing options for the adolescent health check-up

  The J1 is financially supported for adolescents aged 13–14. The association of statutory health insurers for Berlin has abolished the J1 for 15-year-olds. Since physical and mental developments happen at very different times and in different ways, it would make sense to approve health check-ups for adolescents aged 15 or 16 years. It may not make sense to talk to every 14-year-old boy about alcohol, drugs, sex, and contraception, but if a boy is aged 16, it usually does make sense.

• Time restrictions in routine practice

  In the first quarter of 2011, 1450 patients presented in my practice some 3100 time. 255 screening examinations U2 to U9 were undertaken. In the context of the practice’s opening times, this translates as a consultation time of 5.07 minutes.

  I gladly take part in adolescent health check-ups, but the reality in daily practice does not really leave any spare capacity for such examinations.