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Prevalence and impact of multiple childhood chronic illnesses
1Institute for Health Policy Studies, University of California, San Francisco.
Insights
Children with multiple chronic conditions experience worse health and higher healthcare use. Even a few chronic conditions significantly increase a child's health problems and service needs.
Area of Science:
- Pediatric Health
- Chronic Disease Epidemiology
- Health Services Research
Background:
- Multiple chronic conditions (MCC) in children are increasingly recognized as a significant public health concern.
- Understanding the prevalence and impact of MCC is crucial for effective healthcare planning and resource allocation.
- Existing research often focuses on single conditions, necessitating a deeper look into the cumulative effects of multiple conditions.
Purpose of the Study:
- To determine the prevalence of multiple chronic conditions in children.
- To assess the impact of multiple chronic conditions on children's health status.
- To evaluate the effect of multiple chronic conditions on healthcare service utilization among children.
Main Methods:
- Analysis of the 1988 National Health Interview Survey on Child Health.
- Utilized a nationally representative sample of 17,710 U.S. children (<18 years).
- Employed stratified cluster sampling of U.S. households for data collection.
Main Results:
- Fewer than 5% of children have two or more chronic conditions; less than 1% have three or more.
- Children with MCC exhibit increased mental and physical health problems, including developmental delay and behavioral issues.
- MCC are associated with significantly higher utilization of health services, including hospital and physician visits, and poorer health status indicators like school absences and activity limitations.
Conclusions:
- Even a small number of chronic conditions in children leads to increased morbidity across various measures.
- Children with multiple chronic conditions require more comprehensive healthcare interventions.
- Findings underscore the importance of addressing the cumulative burden of chronic diseases in pediatric populations.
Objective:
To determine the prevalence and impact of multiple chronic conditions on children's health status and utilization of health services.
Design:
Analysis of the 1988 National Health Interview Survey on Child Health.
Setting:
Nationally representative sample of the U.S. civilian, noninstitutionalized population.
Participants:
A total of 17,710 children less than 18 years of age selected in a stratified cluster sampling of U.S. households.
Intervention:
None.
Results:
We estimated that fewer than 5% of children have multiple (two or more) chronic conditions and that less than 1% of children had three or more such conditions. However, despite this low overall prevalence, some notable features of multiple chronic conditions stand out. Many of the most prevalent condition-pairs were allergy related, and the rates of co-occurrence of these disorders were generally higher than would be predicted on the basis of prevalence rates for the individual conditions. Children with multiple chronic conditions had more mental and physical health problems and used substantially more health services than other children. For example, the prevalence of developmental delay, learning disabilities, and emotional and behavioral problems increased sharply with the number of chronic conditions reported. Notable deterioration in such health status measures as days in bed, school absences, and activity limitation was also observed with increasing numbers of chronic conditions. Similarly, utilization of hospital and physician services increased in tandem with increasing numbers of chronic conditions.
Conclusions:
Children who have multiple conditions of a chronic nature, even if few in number, have increased morbidity across a variety of measures.