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

VL - 102

SP - 617

EP - 623

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

IS - 7

ER -