The association of economic difficulties with social and health care costs of children-target trial emulation using complete birth cohort data in Finland.

Autor:	Hiilamo A; Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany.; Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Rostock, Germany., Keski-Säntti M; Department of Data and Analytics, Finnish Institute for Health and Welfare, Helsinki, Finland., Juutinen A; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland., Mäkinen L; Itla Children's Foundation, Helsinki, Finland., Ristikari T; Itla Children's Foundation, Helsinki, Finland., Lallukka T; Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Jazyk:	angličtina
Zdroj:	European journal of public health [Eur J Public Health] 2024 Sep 17. Date of Electronic Publication: 2024 Sep 17.
DOI:	10.1093/eurpub/ckae140
Abstrakt:	It is unclear how much costs economic difficulties in families with children incur to the health and social care sector. We examined the health and social service costs after families entered into, and transitioned out of, social assistance used as a proxy measure for economic difficulties. We analyzed register data on all Finnish children born in 1997 and used the non-randomized target trial framework. The two target trials of entry to economic difficulties (social assistance) and continued economic difficulties included 697 680 and 71 131 children-year observations, respectively, in total. Inverse probability treatment weighting techniques were used to make the comparison group similar to the treatment group in terms of health, socioeconomic and demographic-related pretreatment variables. Entry to social assistance use was associated with some 1511-2619€ (50% compared to the control group) higher cumulative health and social care costs of the children three years after their families transitioned to social assistance, compared to the group that did not enter to social assistance system. This difference was primarily attributed to higher social care costs. Continued social assistance use was associated with some 1007-2709€ (31%) higher costs compared to the comparison group that exited social assistance. These findings support an economic argument to prevent families from entering economic difficulties and to help those in such situations to transition out. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)
Databáze:	MEDLINE
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