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Patterns and costs of health-care utilisation in Australian children: The first 5 years
Alison J Hayes1, Victoria Brown2,3, Eng Joo Tan1
1Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Insights
Children from disadvantaged backgrounds, particularly boys, utilized more healthcare in their first two years. Ensuring access to affordable primary care is key for health equity.
Area of Science:
- Pediatric Health Services Research
- Health Economics
- Social Determinants of Health
Background:
- Early childhood health-care utilization and costs are critical for understanding population health trends.
- Disadvantaged populations often experience unique health-care needs and access barriers.
- Identifying factors associated with high health-care use can inform targeted interventions.
Purpose of the Study:
- To describe health-care utilization and costs for Australian children up to age 5.
- To investigate demographic factors linked to high health-care utilization in early childhood.
- To inform policies promoting equitable access to health services for young children.
Main Methods:
- Secondary analysis of linked health-care data for 350 children from a disadvantaged Sydney area.
- Data included primary/secondary care consults, hospitalizations, and emergency visits from birth to 5 years.
- Multivariable logistic regression analyzed associations between child/family characteristics and high health-care use.
Main Results:
- Higher health-care utilization (12 visits/year, AUD 1400/child) and costs occurred in the first 2 years versus years 3-5 (8 visits/year, AUD 900/child).
- Primary care constituted 86% of encounters but only 30% of costs.
- Being male, mother not married/de facto, and household income < AUD 40,000 were associated with high use in the first 2 years; no demographic links found for years 3-5.
Conclusions:
- Children from low-income or single-parent families may need extra support in the first two years.
- Maintaining accessible, low-cost primary health care is essential for health equity among disadvantaged families.
Aim:
To describe patterns of health-care utilisation and costs of a cohort of Australian children in the first 5 years of life and to investigate demographic factors associated with high health-care utilisation.
Methods:
This was a secondary data analysis of prospectively linked health-care utilisation data, including primary and secondary health-care consults, hospitalisations and emergency. The subjects were 350 children from a disadvantaged area of Sydney. Outcomes were the frequency and cost of all health-care consults from birth to 5 years of age. Multivariable logistic regression examined the odds of being a high health-care user in relation to child and family characteristics.
Results:
Children had more health-care consults and higher annual health-care costs in the first 2 years of life (mean 12 health-care visits per year, mean cost Australian dollars (AUD) 1400 per child) than in the next 3 years (8 visits per year, AUD 900 per child). Primary care consults formed 86% of all health-care encounters but only contributed to 30% of the total costs. Factors positively associated with frequent use of health care in the first 2 years of life included being male, mother not married/de facto and annual household income of less than AUD 40000. Frequent users mostly accessed primary care services. There was no association between demographic factors and frequent use of health care in years 3-5 of life.
Conclusions:
Children from low-income or single-parent families may require additional support services during the first 2 years of life. Maintaining or increasing access to free or very low-cost primary health-care services for disadvantaged families will promote equity in health.
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