Conflict of interests: All authors have no competing interests to declare.
Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study
Article first published online: 13 JUN 2014
© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 50, Issue 10, pages 768–774, October 2014
How to Cite
Quach, J., Oberklaid, F., Gold, L., Lucas, N., Mensah, F. K. and Wake, M. (2014), Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study. Journal of Paediatrics and Child Health, 50: 768–774. doi: 10.1111/jpc.12649
- Issue published online: 6 OCT 2014
- Article first published online: 13 JUN 2014
- Manuscript Accepted: 27 APR 2014
- Commonwealth Department of Social Services
- Victorian Government's Operational Infrastructure Program
- Victorian Department of Education and Early Child Development
- Australian National Health and Medical Research Council. Grant Numbers: 436914, 1037449, 1035100, 1046518
- health service research;
- longitudinal study;
- special health care need
We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non-hospital health-care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN.
Data from the first two biennial waves of the nationally representative Longitudinal Study of Australian Children, comprising two independent cohorts recruited in 2004, at ages 0–1 (n = 5107) and 4–5 (n = 4983) years. Exposure condition: parent-reported Children with Special Health Care Needs Screener at both waves, spanning ages 0–7 years. Outcome measure: Federal Government Medicare expenditure, via data linkage to the Medicare database, on non-hospital health-care attendances and prescriptions from birth to 8 years.
At both waves and in both cohorts, >92% of children had complete SHCN and Medicare data. The proportion of children with SHCN increased from 6.1% at age 0–1 years to 15.0% at age 6–7 years. Their additional Medicare costs ranged from $491 per child at 6–7 years to $1202 at 0–1 year. This equates to an additional $161.8 million annual cost or 0.8% of federal funding for non-hospital-based health care. In both cohorts, costs were highest for children with persistent SHCNs.
SHCNs incur substantial non-hospital costs to Medicare, and no doubt other sources of care, from early childhood. This suggests that economic evaluations of early prevention and intervention services for SHCNs should consider impacts on not only the child and family but also the health-care system.