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Increased healthcare utilisation among atopic children in a general practice database: a nested index-control study
David Hj Pols1, Mark Mj Nielen2, Arthur M Bohnen3
1Lecturer, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
Children with atopic disorders, such as eczema, asthma, and allergic rhinitis, utilize general practice resources more frequently than their non-atopic peers. This increased healthcare use extends beyond their diagnosed conditions.
Area of Science:
- Pediatric Healthcare Utilization
- General Practice Research
- Atopic Disorders Epidemiology
Background:
- Atopic eczema, asthma, and allergic rhinitis (AR) represent significant burdens on general practice resources.
- Understanding healthcare resource utilization in children with atopic disorders (ADs) is crucial for effective management and resource allocation.
Purpose of the Study:
- To investigate the patterns of general practice resource use, including consultations, telephone contacts, and home visits, among children diagnosed with atopic disorders (ADs).
Main Methods:
- A nested index-control study design was employed, selecting children aged 2-18 years from a representative general practice database in 2014.
- Children with physician-diagnosed ADs were matched with non-atopic controls based on age and sex within the same general practice.
- The number and frequency of contacts with general practitioners (GPs) were calculated for both atopic and non-atopic groups.
Main Results:
- Children with atopic eczema (80%), asthma (80%), and AR (82%) consulted GPs more often than controls (67%, 65%, 66% respectively).
- Children with all three ADs had the highest GP consultation rate (91% vs. 68% for controls).
- Contact frequency was higher for children with ADs (e.g., 2.8 times/year for atopic eczema vs. 1.9 for controls), but AD-related consultations explained only a portion of the increased utilization.
Conclusions:
- Atopic children demonstrate significantly higher utilization of general practice resources compared to non-atopic children.
- A substantial portion of increased healthcare use in atopic children is for health issues unrelated to their diagnosed atopic conditions.
- Further research is needed to understand the full spectrum of healthcare needs driving increased resource use in this population.
Background:
Atopic eczema, asthma, and allergic rhinitis (AR) create a serious burden on general practice resources.
Aim:
To investigate the use of general practice resources (that is, consultation visits, telephone contacts, and home visits) in children with physician-diagnosed atopic disorders (ADs).
Design & Setting:
In a nested index-control study design, all children (here defined as individuals aged 2-18 years) listed in a representative general practice database were selected in 2014.
Method:
Children diagnosed with ADs were matched on age and sex with non-atopic controls within the same practice. For all the different groups, the number and frequency of children contacting the GP were calculated.
Results:
Of the children with atopic eczema (n = 15 202), 80% consulted the GP in 2014 (controls = 67%). Of the children with asthma (n = 7754), 80% consulted the GP (controls = 65%), and for children with AR (n = 6710), this was 82% (controls = 66%). Of the children with all three ADs, 91% consulted the GP (controls = 68%). On average, a child with atopic eczema contacted the GP 2.8 times/year (controls = 1.9); for children with asthma, the contact frequency was 3.0 (controls = 1.9); and for AR, 3.2 (controls = 1.9). For children with all three ADs, the contact frequency was 4.3 (controls = 2.0). Consultations related to the ADs investigated only explain a smaller part of the increased healthcare utilisation in atopic children.
Conclusion:
Atopic children use more general practice resources compared to non-atopic children, yet frequently for morbidity or other health-related questions not related to one of the ADs.
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