Social and ethnic group differences in healthcare use by children aged 0–14 years: a population-based cohort study in England from 2007 to 2017
| Autor: | Charles Coughlan, Behrouz Nezafat Maldonado, Mitch Blair, Alex Bottle, Dougal S Hargreaves, Francesca K Neale, Sonia Saxena, Judith Ruzangi |
|---|---|
| Přispěvatelé: | NIHR, Research Trainees Coordinating Centre, National Institute of Health and Medical Research |
| Rok vydání: | 2021 |
| Předmět: |
General Practice
Ethnic group Pediatrics State Medicine Cohort Studies 0302 clinical medicine DISPARITIES ADOLESCENTS Epidemiology Ethnicity 030212 general & internal medicine Child Referral and Consultation Original Research education.field_of_study 030503 health policy & services Attendance Health services research health services research Hospitalization England Child Preschool Cohort INEQUALITIES epidemiology Emergency Service Hospital 0305 other medical science Life Sciences & Biomedicine medicine.medical_specialty Adolescent Population Black People CULTURAL COMPETENCE 1117 Public Health and Health Services 03 medical and health sciences Asian People medicine Humans Healthcare Disparities education Retrospective Studies Science & Technology business.industry Racial Groups Infant Newborn Infant 1103 Clinical Sciences Retrospective cohort study Health Status Disparities Emergency department Patient Acceptance of Health Care Socioeconomic Factors Pediatrics Perinatology and Child Health 1114 Paediatrics and Reproductive Medicine business Demography |
| Zdroj: | Archives of Disease in Childhood |
| ISSN: | 1468-2044 0003-9888 |
| DOI: | 10.1136/archdischild-2020-321045 |
| Popis: | Objective To describe social and ethnic group differences in children’s use of healthcare services in England, from 2007 to 2017. Design Population-based retrospective cohort study. Setting/Patients We performed individual-level linkage of electronic health records from general practices and hospitals in England by creating an open cohort linking data from the Clinical Practice Research Datalink and Hospital Episode Statistics. 1 484 455 children aged 0–14 years were assigned to five composite ethnic groups and five ordered groups based on postcode mapped to index of multiple deprivation. Main outcome measures Age-standardised annual general practitioner (GP) consultation, outpatient attendance, emergency department (ED) visit and emergency and elective hospital admission rates per 1000 child-years. Results In 2016/2017, children from the most deprived group had fewer GP consultations (1765 vs 1854 per 1000 child-years) and outpatient attendances than children in the least deprived group (705 vs 741 per 1000 child-years). At the end of the study period, children from the most deprived group had more ED visits (447 vs 314 per 1000 child-years) and emergency admissions (100 vs 76 per 1000 child-years) than children from the least deprived group. In 2016/2017, children from black and Asian ethnic groups had more GP consultations than children from white ethnic groups (1961 and 2397 vs 1824 per 1000 child-years, respectively). However, outpatient attendances were lower in children from black ethnic groups than in children from white ethnic groups (732 vs 809 per 1000 child-years). By 2016/2017, there were no differences in outpatient, ED and in-patient activity between children from white and Asian ethnic groups. Conclusions Between 2007 and 2017, children living in more deprived areas of England made greater use of emergency services and received less scheduled care than children from affluent neighbourhoods. Children from Asian and black ethnic groups continued to consult GPs more frequently than children from white ethnic groups, though black children had significantly lower outpatient attendance rates than white children across the study period. Our findings suggest substantial levels of unmet need among children living in socioeconomically disadvantaged areas. Further work is needed to determine if healthcare utilisation among children from Asian and black ethnic groups is proportionate to need. Population-based retrospective cohort study using individual linked data from 2007 to 2017 show social and ethnic group differences in children’s use of healthcare services in England, with deprivation associated with higher emergency and lower scheduled care use. |
| Databáze: | OpenAIRE |
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