Determinants of Hospital-Based Health Service Utilization in Cerebral Palsy: a Systematic Review

Paget, Simon P; Ostojic, Katarina; Goldsmith, Shona; Nassar, Natasha; McIntyre, Sarah

doi:10.1016/j.apmr.2021.12.003

Cited by 8 publications

(14 citation statements)

References 49 publications

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“…Our findings suggest that studies with populations derived from hospital admission data will include a population with more comorbidities and greater severity. These factors are known to be associated with greater health service utilisation 26 and adverse health outcomes 27,28 and results based on such populations are likely to overstate these (negative) outcomes. We also noted that children with CP identified from hospital admission data were more likely to be older than those from a CP register.…”

Section: Discussionmentioning

confidence: 99%

A comparison of cohorts of children with cerebral palsy from a population register and hospital admission data: A data linkage study

Paget,

McIntyre,

Lain

et al. 2023

Paediatric Perinatal Epid

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BackgroundAdministrative health data, such as hospital admission data, are often used in research to identify children/young people with cerebral palsy (CP).ObjectivesTo compare sociodemographic, clinical details and mortality of children/young people identified as having CP in either a CP population registry or hospital admission data.MethodsWe identified two cohorts of children/young people (birth years 2001–2010, age at study end or death 2 months to 19 years 6 months) with a diagnosis of CP from either (i) the New South Wales (NSW)/Australian Capital Territory (ACT) CP Register or (ii) NSW hospital admission data (2001–2020). Using record linkage, these data sources were linked to each other and NSW Death, Perinatal, and Disability datasets. We determined the sensitivity and positive predictive value (PPV) of CP diagnosis in hospital admission data compared with the NSW/ACT CP Register (gold standard). We then compared the sociodemographic and clinical characteristics and mortality of the two cohorts available through record linkage using standardised mean difference (SMD).ResultsThere were 1598 children/young people with CP in the NSW/ACT CP Register and 732–2439 children/young people with CP in hospital admission data, depending on the case definition used. The sensitivity of hospital admission data for diagnosis of CP ranged from 0.40–0.74 and PPV 0.47–0.73. Compared with children/young people with CP identified in the NSW/ACT CP Register, a greater proportion of those identified in hospital admission data (one or more admissions with G80 case definition) were older, lived in major cities, had comorbidities including epilepsy, gastrostomy use, intellectual disability and autism, and died during the study period (SMD > 0.1).ConclusionsSociodemographic and clinical characteristics differ between cohorts of children/young people with CP identified using a CP register or hospital admission data. Those identified in hospital admission data have higher rates of comorbidities and death, suggesting some may have progressive conditions and not CP. These differences should be considered when planning and interpreting research using various data sources.

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Section: Discussionmentioning

confidence: 99%

A comparison of cohorts of children with cerebral palsy from a population register and hospital admission data: A data linkage study

Paget,

McIntyre,

Lain

et al. 2023

Paediatric Perinatal Epid

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“…Thus, children with cerebral palsy often have greater health and social needs, and service demands than their peers without cerebral palsy. 4 5 This includes frequent and repeated interaction with services including tertiary specialised healthcare services and community-based therapy. Best practice involves a multidisciplinary team framework guided by the International Classification of Functioning, Health and Disability model.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, children with cerebral palsy often have greater health and social needs, and service demands than their peers without cerebral palsy 4 5. This includes frequent and repeated interaction with services including tertiary specialised healthcare services and community-based therapy.…”

Section: Introductionmentioning

confidence: 99%

Codesigning a social prescribing pathway to address the social determinant of health concerns of children with cerebral palsy and their families in Australia: a protocol for a mixed-methods formative research study

et al. 2023

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IntroductionSocial determinants of health (SDH) are contributors to health inequities experienced by some children with cerebral palsy and pose barriers to families engaging with complex and fragmented healthcare systems. There is emerging evidence to support ‘social prescribing’ interventions that systematically identify SDH concerns and refer patients to non-medical social care support and services to address their needs. To date, social prescribing has not been trialled specifically for children with neurodevelopmental disabilities, including cerebral palsy, in Australia. This study aims to codesign a social prescribing programme to address SDH concerns of children with cerebral palsy and their families who attend one of the three tertiary paediatric rehabilitation services in New South Wales, Australia.Methods and analysisThis is a qualitative multi-site study conducted at the three NSW paediatric hospitals’ rehabilitation departments using a codesign approach. Children aged 12–18 years with cerebral palsy, parents/caregivers of children (aged 0–18 years) with cerebral palsy, and clinicians will be involved in all stages to codesign the social prescribing programme. The study will consist of three components: (1) ‘what we need’, (2) ‘creating the pathways’ and (3) ‘finalising and sign off’. This project is overseen by two advisory groups: one group of young adults with cerebral palsy and one group of parents of young people with cerebral palsy. The study will be guided by the biopsychosocial ecological framework, and analysis will follow Braun and Clark’s thematic approach.Ethics and disseminationThe study protocol was approved by the human research ethics committee of the Sydney Children’s Hospitals Network. This codesign study will inform a future pilot study of feasibility and acceptability, then if indicated, a pilot clinical trial of efficacy. We will collaborate with all project stakeholders to disseminate findings and undertake further research to build sustainable and scalable models of care.Trial registration numberACTRN12622001459718.

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“…In which, Anderson’s framework is one of the most widely used frameworks that present dynamic and recursive relationships between contextual characteristics, individual characteristics, and health service utilization [ 22 ]. The model identifies three clusters of individual characteristics, namely predisposing characteristics, enabling resources, and perceived needs [ 19 , 23 ]. Predisposing characteristics include variables, such as age, gender, education level, and health beliefs.…”

Section: Introductionmentioning

confidence: 99%

Trends and Impact Factors of Mental Health Service Utilization among Resettled Humanitarian Migrants in Australia: Findings from the BNLA Cohort Study

Zheng

Chen

Yan

et al. 2022

IJERPH

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Resettled humanitarian migrants (HMs) have high levels of mental disorders, but factors associated with the utilization of mental health services (MHS) are poorly understood. We aimed to explore trends and impact factors of MHS utilization among HMs in the process of resettlement in Australia. A total of 2311 HMs from the 1st (2013), 3rd, and 5th (2018) waves of a national cohort study were included. MHS utilization in the past year was assessed by two indicators: having MHS contacts and the frequency of MHS contacts. Trends were identified by Cochran–Armitage tests, and generalized linear mixed models and ordered logistic models were fitted to explore impact factors of MHS utilization. The proportion of having MHS contacts significantly rose from 13.0% to 29.4% over the five years. MHS utilization was mainly driven by perceived needs, such as post-traumatic stress disorders and the degree of post-migration stress. Unemployment and strong belongingness to the local community were also associated with having MHS contacts. No significant gender difference was found in having MHS contacts but females tended to contact MHS more frequently. Resettled HMs have a persistent dilemma of high mental illness prevalence and MHS underutilization. Sustainable mental health education and long-term resettlement services targeted at social integration that consider gender difference are urgently needed in host countries.

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Determinants of Hospital-Based Health Service Utilization in Cerebral Palsy: a Systematic Review

Cited by 8 publications

References 49 publications

A comparison of cohorts of children with cerebral palsy from a population register and hospital admission data: A data linkage study

A comparison of cohorts of children with cerebral palsy from a population register and hospital admission data: A data linkage study

Codesigning a social prescribing pathway to address the social determinant of health concerns of children with cerebral palsy and their families in Australia: a protocol for a mixed-methods formative research study

Trends and Impact Factors of Mental Health Service Utilization among Resettled Humanitarian Migrants in Australia: Findings from the BNLA Cohort Study

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