Predictors of children's health system use: cross-sectional study of linked data
Predictors of children's health system use: cross-sectional study of linked data
BACKGROUND: Use of health services is increasing in many countries. Most health service research exploring determinants of use has focused on adults and on secondary care. Less is known about factors associated with the use of the emergency department (ED) and general practice (GP) among young children. OBJECTIVE: To explore factors associated with GP consultations and ED attendances among children under 5 in a single UK city. METHODS: Cross-sectional exploratory study using anonymized individual-level health service use data for children aged 0-4 from 21 GPs in Southampton, UK, linked to ED data, over a 1-year period. Univariate and multivariable logistic regression were used to explore the association of socio-demographic factors [using the 2015 Index of Multiple Deprivation (IMD) to define socio-economic status] with high service use (defined as more than eight GP consultations and/or two ED attendances respectively). RESULTS: Among 11 062 children, there were 76 092 GP consultations and 6107 ED attendances. Three thousand two hundred thirty-three (29%) children were high users of GP and 564 (5%) of ED services. Greater socio-economic deprivation was independently associated with high use of GP and ED services separately [odds ratios (OR) for most versus least deprived IMD quintile 1.45 (95% confidence interval, CI 1.20-1.75) and 2.21 (95% CI 1.41-3.46), respectively], and together [OR 2.62 (95% CI 1.48-4.65)]. CONCLUSION: Young children are frequent users of health services, particularly GP. Socio-economic deprivation is an important factor. Parents, carers and health services may benefit from interventions that support families in their management of children's health.
Children, cross-sectional study, emergency department, general practice, health services, socio-economic factors
807-814
Perrin, Rebecca
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Patel, Sanjay
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Lees, Amanda
882f4aea-28ee-458c-b164-6109732b8714
Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Woodcock, Tina
47fab05d-2843-4765-80b1-eb1d1b0d343d
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
28 November 2020
Perrin, Rebecca
0d7d9086-7d67-4038-8857-3ed3dc60cee4
Patel, Sanjay
bc976df6-0414-459f-8390-3eca85e07d97
Lees, Amanda
882f4aea-28ee-458c-b164-6109732b8714
Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Woodcock, Tina
47fab05d-2843-4765-80b1-eb1d1b0d343d
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Perrin, Rebecca, Patel, Sanjay, Lees, Amanda, Smith, Dianna, Woodcock, Tina, Harris, Scott and Fraser, Simon
(2020)
Predictors of children's health system use: cross-sectional study of linked data.
Family Practice, 37 (6), , [cmaa061].
(doi:10.1093/fampra/cmaa061).
Abstract
BACKGROUND: Use of health services is increasing in many countries. Most health service research exploring determinants of use has focused on adults and on secondary care. Less is known about factors associated with the use of the emergency department (ED) and general practice (GP) among young children. OBJECTIVE: To explore factors associated with GP consultations and ED attendances among children under 5 in a single UK city. METHODS: Cross-sectional exploratory study using anonymized individual-level health service use data for children aged 0-4 from 21 GPs in Southampton, UK, linked to ED data, over a 1-year period. Univariate and multivariable logistic regression were used to explore the association of socio-demographic factors [using the 2015 Index of Multiple Deprivation (IMD) to define socio-economic status] with high service use (defined as more than eight GP consultations and/or two ED attendances respectively). RESULTS: Among 11 062 children, there were 76 092 GP consultations and 6107 ED attendances. Three thousand two hundred thirty-three (29%) children were high users of GP and 564 (5%) of ED services. Greater socio-economic deprivation was independently associated with high use of GP and ED services separately [odds ratios (OR) for most versus least deprived IMD quintile 1.45 (95% confidence interval, CI 1.20-1.75) and 2.21 (95% CI 1.41-3.46), respectively], and together [OR 2.62 (95% CI 1.48-4.65)]. CONCLUSION: Young children are frequent users of health services, particularly GP. Socio-economic deprivation is an important factor. Parents, carers and health services may benefit from interventions that support families in their management of children's health.
Text
Paeds Data Paper May2 0v0.19 for 2nd submission
- Accepted Manuscript
More information
Accepted/In Press date: 8 June 2020
e-pub ahead of print date: 7 July 2020
Published date: 28 November 2020
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© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Keywords:
Children, cross-sectional study, emergency department, general practice, health services, socio-economic factors
Identifiers
Local EPrints ID: 441507
URI: http://eprints.soton.ac.uk/id/eprint/441507
ISSN: 0263-2136
PURE UUID: d75bb437-0a79-4055-8054-17a584ec70e0
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Date deposited: 16 Jun 2020 16:31
Last modified: 17 Mar 2024 05:39
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Contributors
Author:
Rebecca Perrin
Author:
Sanjay Patel
Author:
Amanda Lees
Author:
Tina Woodcock
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