TY - JOUR
T1 - Impact of functional somatic symptoms on 5-7-year-olds' healthcare use and costs
AU - Græsholt-Knudsen, Troels
AU - Skovgaard, Anne Mette
AU - Jensen, Jens Søndergaard
AU - Rask, Charlotte Ulrikka
PY - 2017/7
Y1 - 2017/7
N2 - Objective: Knowledge about childhood functional somatic symptoms (FSS) and healthcare costs is scarce. This study aims to assess whether FSS in children aged 5-7 years are associated with increased future primary healthcare. Design: At baseline of the observational cohort study, between years 2005 and 2007, 1327 children from the Copenhagen Child Cohort were assessed at ages 5-7 years for FSS and chronic physical diseases using the Soma Assessment Interview. Information on primary healthcare use was obtained from the National Health Insurance Service Register, and measured as the price of all medical services outside the hospital during a 4.5-year follow-up period from the day of assessment. Regression with bootstrap bias-corrected and accelerated CIs were performed. Results: 1018 (76.8%) children had no FSS with primary healthcare use adjusted for other child health problems, maternal education and family changes of 448.2, 388.2-523.8 and number of face-to-face contacts: 11.90, 10.71-13.25; 250 (18.9%) had FSS with healthcare use 441.0, 355.0-550.3 and face-to-face contacts: 11.22, 9.60-12.91, and 58 (4.4%) had impairing FSS with healthcare use: 625.9, 447.9-867.8 and face-to-face contacts: 14.65, 11.20-19.00. In unadjusted regression analysis, impairing FSS were associated with increased healthcare use (increased costs: 246.0, 67.6-494.3). The adjusted association was slightly attenuated (increased costs: 177.8, 1.3-417.0). Conclusions: Impairing FSS in children aged 5-7 years is a predictor for the child's future primary healthcare use. More research on complex predictive models is needed to further explore the clinical significance of these results, and to contribute to the underpinning of early interventions towards impairing FSS in children.
AB - Objective: Knowledge about childhood functional somatic symptoms (FSS) and healthcare costs is scarce. This study aims to assess whether FSS in children aged 5-7 years are associated with increased future primary healthcare. Design: At baseline of the observational cohort study, between years 2005 and 2007, 1327 children from the Copenhagen Child Cohort were assessed at ages 5-7 years for FSS and chronic physical diseases using the Soma Assessment Interview. Information on primary healthcare use was obtained from the National Health Insurance Service Register, and measured as the price of all medical services outside the hospital during a 4.5-year follow-up period from the day of assessment. Regression with bootstrap bias-corrected and accelerated CIs were performed. Results: 1018 (76.8%) children had no FSS with primary healthcare use adjusted for other child health problems, maternal education and family changes of 448.2, 388.2-523.8 and number of face-to-face contacts: 11.90, 10.71-13.25; 250 (18.9%) had FSS with healthcare use 441.0, 355.0-550.3 and face-to-face contacts: 11.22, 9.60-12.91, and 58 (4.4%) had impairing FSS with healthcare use: 625.9, 447.9-867.8 and face-to-face contacts: 14.65, 11.20-19.00. In unadjusted regression analysis, impairing FSS were associated with increased healthcare use (increased costs: 246.0, 67.6-494.3). The adjusted association was slightly attenuated (increased costs: 177.8, 1.3-417.0). Conclusions: Impairing FSS in children aged 5-7 years is a predictor for the child's future primary healthcare use. More research on complex predictive models is needed to further explore the clinical significance of these results, and to contribute to the underpinning of early interventions towards impairing FSS in children.
KW - Epidemiology
KW - General Paediatrics
KW - Health services research
KW - Medically unexplained symptoms
KW - Somatoform disorders
UR - http://www.scopus.com/inward/record.url?scp=85012012626&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2016-311808
DO - 10.1136/archdischild-2016-311808
M3 - Journal article
C2 - 28137707
AN - SCOPUS:85012012626
SN - 0003-9888
VL - 102
SP - 617
EP - 623
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 7
ER -