In this investigation performed in pediatric patients in Västra Götalandsregionen in Sweden we concluded that as many as 20 % of the children had long-term and/or more extensive contact with the health care system. We used two different methods, combining professional clinical judgement with data from the health care production register in Västra Götalandsregionen, to define the incidence of chronic diseases among the pediatric population. The spectrum of diseases observed is broad, spanning up to 20 different diagnostic areas. Furthermore, the number of children with special health care needs increases over time. The high incidence and definition of chronic illness and complex needs amongst our children and adolescents need to be taken into consideration.

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