Introduction: On the referral patterns only rough information is available from national statistics. The aim of this study is to determine how often, to which specialties and for what conditions children in different age groups are referred.

Methods: From data of the Dutch National Survey of Morbidity and Interventions in General Practice we analysed new referrals of all 63,753 children (0 to 14 years) from 161 participating GPs who registered covering a whole year.

Results: The referral rate per 1000 children per year varies by age from 231 for O-year-olds to 119 for 10-14 years (mean 159). Specialties mainly involved are: ENT, pediatrics, surgery, ophtalmology, dermatology and orthopedics. In the first year of life pediatrics has the highest referral rate (123), for the other age-groups it decreases (mean 36). Referrals to ENT-specialists regard mostly 1-4 and 5-9 olds (71/53). For surgery the referral rate increases by age from 19 to 34. Differences between boys and girls are small, except for surgery. The highest referral rate have respiratory (28), musculoskeletal (25), ear (24) and eye (21) problems. The part the ten most frequently referred diagnoses form of all referrals varies from 35% to 83%.

Conclusions: The need for specialistic care in childhood is clarified by this overview of referrals made by GPs for secondary care with detailed information for the different age categories, involved specialties and the variation in morbidity presented to specialists.