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Utilization of Healthcare Services in Patients with Chronic Diseases under 18 Years Old: Differences and Contributing
Jaime Barrio-Cortes1,2,3,4, Beatriz Benito-Sánchez1, Raquel Sánchez-Ruano1,5
1Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), 28003 Madrid, Spain.
Insights
Children with chronic conditions utilize primary care (PC) extensively, with factors like complexity and female sex influencing visits. Hospital care (HC) use was linked to thyroid disorders in this pediatric study.
Area of Science:
- Pediatric Healthcare Utilization
- Chronic Condition Management
- Health Services Research
Background:
- Pediatric patients with chronic conditions often experience fragmented care and unmet needs.
- These patients represent a significant user group of both primary care (PC) and hospital care (HC) services.
- Understanding service utilization patterns is crucial for optimizing care delivery.
Purpose of the Study:
- To analyze differences in PC and HC service utilization among pediatric patients with chronic conditions.
- To identify factors associated with PC and HC utilization, including sex, age, and disease complexity.
- To inform the development of patient-centered care models for improved outcomes.
Main Methods:
- A cross-sectional study was conducted in a Madrid health area.
- Included pediatric patients (under 18) with at least one chronic condition.
- Data analyzed included demographics, diagnoses, and healthcare contacts (PC and HC).
Main Results:
- 15.7% of pediatric patients had chronic conditions; 3.5% had complexity and 11.3% had multimorbidity.
- Mean annual healthcare contacts were 9.1 (8.3 PC, 0.8 HC).
- PC utilization associated with complexity, female sex, European origin, and specific conditions (asthma, epilepsy, ADHD, etc.); older age showed negative association. Thyroid disorders linked to HC use.
Conclusions:
- Significant differences exist in PC and HC utilization among pediatric chronic patients based on various factors.
- Identifying these factors can guide targeted interventions and care coordination.
- Optimizing care delivery can reduce healthcare utilization and enhance patient quality of life.
Abstract:
Pediatric patients with chronic conditions frequently have unmet care needs, make extensive use of healthcare services, and often encounter fragmented, non-centered care. This study aimed to analyze the differences in the utilization of primary care (PC) and hospital care (HC) services by these patients according to sex, age, and complexity and to identify associated factors. A cross-sectional study was conducted in a basic health area of Madrid, including patients under 18 years. Among these patients, 15.7% had ≥1 chronic disease, 54.1% were male, the average age was 9.5 years, 3.5% had complexity, and 11.3% had multimorbidity. The mean number of contacts/year with the healthcare system was 9.1, including 8.3 contacts/year with PC (4.9 with pediatricians and 1.9 with nurses) and 0.8 contacts/year with HC (0.8 in external consultations and 0.01 hospitalizations). The factors associated with PC utilization were complexity; female sex; European origin; and diseases like asthma, epilepsy, stroke, recurrent urinary infection, attention deficit hyperactivity disorder, and anxiety, while older age was negatively associated. Thyroid disorders were significantly associated with HC utilization. These findings could help guide the design of optimized pediatric patient-centered care approaches to coordinate care across healthcare services and reduce high healthcare utilization, therefore improving the healthcare outcomes and quality of life for these patients.
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