Health care resource use in preschool children with cerebral palsy
Tiffany Easton1,2, Roslyn N Boyd3, Paul A Scuffham1,2
1Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Insights
Children with cerebral palsy (CP) incur significant healthcare costs, particularly those with greater motor impairments and more comorbidities. These costs remain stable as children age from 18 months to 5 years.
Area of Science:
- Pediatrics
- Public Health
- Health Economics
Background:
- Cerebral palsy (CP) presents a significant burden on healthcare systems.
- Understanding factors influencing healthcare resource use (HCRU) in young children with CP is crucial for resource allocation and management.
Purpose of the Study:
- To estimate the disease burden associated with CP in young children.
- To identify factors influencing healthcare resource use and costs in this population.
Main Methods:
- A prospective, longitudinal cohort study was conducted in Queensland, Australia, involving children with CP born between 2006 and 2009.
- Health care resource use questionnaires were administered at six time points, collecting data on resource utilization, socio-demographics, and disease severity.
- Costs were calculated from the healthcare funder's perspective using data from Medicare, the Australian National Hospital Cost Data Collection, and market prices.
Main Results:
- Physiotherapy was the most common allied health service utilized (94%).
- Nearly half of the participants (45%) experienced at least one hospital admission.
- The average annual cost per child with CP was A$24,950, with higher costs linked to increased motor impairment and comorbidities.
Conclusions:
- Healthcare resource use in preschool children with CP can be stratified by disease severity.
- Increased motor impairments and comorbidities are significant drivers of higher healthcare costs in children with CP.
- Hospitalization costs were particularly elevated in children with a higher number of comorbidities, with no significant cost changes observed between 18 months and 5 years of age.
Aim:
To estimate the burden of disease and evaluate which factors affect health care resource use (HCRU) in young children with cerebral palsy (CP).
Method:
Data were collected as part of a prospective, longitudinal cohort study of children with CP born in Queensland, Australia between 2006 and 2009. HCRU questionnaires were administered at six time points. Data on resource use, socio-demographics, and disease severity were collected. Costs were sourced from Medicare, the Australian National Hospital Cost Data Collection, and market prices. A generalized linear model was used to identify factors influencing CP-related costs.
Results:
A total of 794 questionnaires were completed by 222 participants (mean = 3.6 per participant). Physiotherapy (94%, n = 208) was the most widely accessed allied health care therapy; almost half of the participants (45%; 354 of 794) reported one or more hospital admissions. From the health care funder perspective, a child with CP costs on average A$24 950 per annum (A$12 475 per 6 months). Higher costs were associated with increased motor impairment (Gross Motor Function Classification System, p < 0.001) and increased comorbidities (p = 0.012).
Interpretation:
HCRU in preschool children with CP can be analysed according to disease severity. Both increased motor impairments and increased comorbidities were associated with higher health care costs.
What This Paper Adds:
Children with a higher number of comorbidities had higher health care costs, and more specifically, higher hospitalization costs. No significant change in costs was found over time as children aged from 18 months to 5 years.
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