Healthcare utilisation patterns for paediatric functional somatic symptom presentation: a 3-year retrospective...

Area of Science:

• Pediatric Healthcare
• Psychosomatic Medicine
• Health Services Research

Background:

• Children and young persons often present to Emergency Departments (EDs) with physical symptoms linked to psychosocial distress.
• This presentation leads to increased healthcare utilization and costs, with limited longitudinal data in Asian contexts.
• This study examines healthcare trajectories and costs for children with possible functional somatic symptoms in Singapore.

Purpose of the Study:

• To characterize three-year healthcare utilization and costs in children presenting with possible functional somatic symptoms to a pediatric ED.
• To identify factors associated with recurrent ED use in this population.

Main Methods:

• Retrospective cohort study of 4,964 patients aged 6-15 years at a tertiary pediatric hospital.
• Follow-up for three years (2018-2021) tracking ED, inpatient, and specialist outpatient care (SOC) use.
• Logistic regression analyzed factors associated with recurrent ED visits beyond Year 1.

Main Results:

• ED revisits decreased by 84.5% and total healthcare costs by 75.6% from Year 1 to Year 3.
• Specialist outpatient care and inpatient admissions remained substantial in Years 2 and 3.
• Younger age, minority ethnicity, and initial inpatient admission predicted recurrent ED visits.

Conclusions:

• Declining ED revisits contrast with persistent specialist and inpatient use, indicating unmet psychosocial needs.
• Specific subgroups (younger age, minority ethnicity, initial inpatient admission) require targeted interventions.
• Integrating psychosocial screening and culturally responsive referrals is crucial for reducing healthcare use and addressing distress.