Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study

Authors

  • Jon Quach,

    Corresponding author
    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    • Correspondence: Dr Jon Quach, Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville, Vic. 3052, Australia. Fax: +61 3 9345 5900; email: jon.quach@mcri.edu.au

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  • Frank Oberklaid,

    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Clinical Epidemiology and Biostatistics Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia
    3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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  • Lisa Gold,

    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Deakin Health Economics, Deakin University, Melbourne, Victoria, Australia
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  • Nina Lucas,

    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Parenting Research Centre, Melbourne, Victoria, Australia
    3. National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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  • Fiona K Mensah,

    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Clinical Epidemiology and Biostatistics Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia
    3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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  • Melissa Wake

    1. Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
    3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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  • Conflict of interests: All authors have no competing interests to declare.

Abstract

Aim

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.

Methods

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.

Results

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.

Conclusions

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.

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