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Children with neurodevelopmental disorders and disabilities: a population-based study of healthcare service
Rubab G Arim1, Anton R Miller2, Anne Guèvremont1
1Health Analysis Division, Statistics Canada, Ottawa, ON, Canada.
Insights
Children with neurodevelopmental disorders and disabilities (NDD/D) use significantly more healthcare services, including prescriptions and hospitalizations, than their peers. This highlights a need for specialized services, particularly for those with co-occurring psychiatric conditions.
Area of Science:
- Pediatric Health Services Research
- Public Health and Epidemiology
- Neurodevelopmental Disorders
Background:
- Neurodevelopmental disorders and disabilities (NDD/D) affect a significant portion of the pediatric population.
- Understanding healthcare service utilization patterns is crucial for effective resource allocation and policy development.
- Linked administrative health data provides a robust method for population-level health services research.
Purpose of the Study:
- To identify children with NDD/D using provincial administrative data.
- To compare healthcare service utilization between children with and without NDD/D.
- To inform policy and service planning for children with NDD/D.
Main Methods:
- Utilized linked administrative health data from the British Columbia Medical Services Plan for children aged 6-10 years.
- Identified and classified NDD/D across six functional domains using diagnostic information.
- Analyzed healthcare service utilization, including physician claims, prescription data, and hospitalizations.
Main Results:
- 8.3% of children were identified with NDD/D.
- Children with NDD/D exhibited substantially higher healthcare service utilization across multiple domains.
- Effect sizes for increased utilization were largest for prescription medication days and number of prescriptions, and medium for physician visits and hospitalizations.
Conclusions:
- Children with NDD/D represent a population with high healthcare service demands.
- The high utilization of psychostimulants suggests a need for integrated NDD/D and psychiatric services.
- Findings underscore the importance of tailored service and resource planning for children with NDD/D.
Aim:
The aim of this study was to identify children with neurodevelopmental disorders and disabilities (NDD/D) and compare their healthcare service utilization to children without NDD/D using provincial linked administrative data.
Method:
The sample included children aged 6 to 10 years (n=183 041), who were registered with the British Columbia Medical Services Plan. Diagnostic information was used for the identification and classification of NDD/D in six functional domains. Healthcare service utilization included outcomes based on physician claims, prescription medication use, and hospitalization.
Results:
Overall, 8.3% of children were identified with NDD/D. Children with NDD/D had higher healthcare service utilization rates than those without NDD/D. Effect sizes were: very large for the number of days a prescription medication was dispensed; large for the number of prescriptions; medium for the number of physician visits, different specialists visited, number of different prescription medications, and ever hospitalized; and small for the number of laboratory visits, X-ray visits, and number of days hospitalized.
Interpretation:
The findings have policy implications for service and resource planning. Given the high use of psychostimulants, specialized services for both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. Future studies may examine patterns of physician behaviours and costs attributable to healthcare service utilization for children with NDD/D.
What This Paper Adds:
Children with neurodevelopmental disorders and disabilities (NDD/D) have higher healthcare service utilization than those without. Based on provincial population-based linked administrative health data, a sizeable number of children are living with NDD/D. Given the high use of psychostimulants, specialized services for children with both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D.
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