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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Use of hospital-based health care services among children aged 1 through 9 years who were born very preterm - a population-based study

Authors: Søren T. Klitkou, Tor Iversen, Hans J. Stensvold, Arild Rønnestad

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Very preterm (VPT) children, with a birth weight below 1500 g or delivered before 32 weeks of gestational age, are at increased risk of poorer long-term health outcomes and higher rates of hospitalization in childhood. However, considerable variation exists in the need for in-hospital care within this population. We assessed the utilization and distribution of hospital-based care from ages 1 through 9 years for a nationwide population.

Methods

This was a population-based cohort of VPT children born in the period 2001–2009. We evaluated their utilization of hospital care in 2008–2010, when aged 1–9 years old. Outcomes were the incidence of hospital admissions and outpatient visits. We used Poisson regression models with multiple imputation of missing data.

Results

Children born VPT had more hospital admissions compared with the general population of children aged 1–9 years. The rates of hospital admissions and outpatient visits were strongly related to clinical characteristics of the child at birth and age at admission/outpatient visit but to only a variable and minor degree to characteristics pertaining to maternal health, the sociodemographic factors, and geographical proximity to hospital services.

Conclusions

Prior to this study, hospital utilization during the period 5–9 years old has been poorly documented. We found that excess utilization of hospital resources on average declines with increasing age. We also noted substantial differences in the use of hospital care across age groups and clinical factors for VPT children. The added information from the health status of mothers, social background, and geographic measures of access was limited.
Appendix
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Footnotes
1
The sum of live births from 2001 to 2010 in our database vs. total for Norway, 7102 vs. 583,045.
 
2
The sum of deaths by age 1 from 2001 to 2010 in our database vs. total for Norway, 828 vs. 1856.
 
Literature
1.
Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;371:261–9.CrossRefPubMed
2.
Nordermoen A, Bratlid D. Costs for treatment of very-low-birth-weight infants. Tidsskr Nor Laegeforen. 2010;130:1130–4.CrossRefPubMed
3.
Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003;102:488–92.PubMed
4.
Leversen KT, Sommerfelt K, Ronnestad A, Kaaresen PI, Farstad T, Skranes J, Støen R, Elgen IB, Rettedal S, Eide GE, et al. Prediction of neurodevelopmental and sensory outcome at 5 years in Norwegian children born extremely preterm. Pediatrics. 2011;127(3):e630–8.CrossRefPubMed
5.
Elgen I, Sommerfelt K, Ellertsen B. Cognitive performance in a low birth weight cohort at 5 and 11 years of age. Pediatr Neurol. 2003;29:111–6.CrossRefPubMed
6.
Husby IM, Skranes J, Olsen A, Brubakk AM, Evensen KA. Motor skills at 23 years of age in young adults born preterm with very low birth weight. Early Hum Dev. 2013;89:747–54.CrossRefPubMed
7.
Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth. The N Engl J Med. 2008;359:262–73.CrossRefPubMed
8.
Petrou S. The economic consequences of preterm birth during the first 10 years of life. BJOG. 2005;112(Suppl 1):10–5.CrossRefPubMed
9.
Smith LK, Draper ES, Manktelow BN, Field DJ. Socioeconomic inequalities in survival and provision of neonatal care: population based study of very preterm infants. BMJ. 2009;339:b4702.CrossRefPubMedPubMedCentral
10.
Gaddlin PO, Finnstrom O, Hellgren K, Leijon I. Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden. Acta Paediatr. 2007;96:499–505.CrossRefPubMed
11.
Gray D, Woodward LJ, Spencer C, Inder TE, Austin NC. Health service utilisation of a regional cohort of very preterm infants over the first 2 years of life. J Paediatr Child Health. 2006;42:377–83.CrossRefPubMed
12.
Larroque B, Ancel PY, Marret S, Marchand L, Andre M, Arnaud C, Pierrat V, Roze JC, Messer J, Thiriez G, et al. Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet. 2008;371:813–20.CrossRefPubMed
13.
Petrou S, Kupek E. Socioeconomic differences in childhood hospital inpatient service utilisation and costs: prospective cohort study. J Epidemiol Community Health. 2005;59:591–7.CrossRefPubMedPubMedCentral
14.
Rautava L, Hakkinen U, Korvenranta E, Andersson S, Gissler M, Hallman M, Korvenranta H, Leipala J, Peltola M, Tammela O, et al. Health and the use of health care services in 5-year-old very-low-birth-weight infants. Acta Paediatr. 2010;99:1073–9.CrossRefPubMed
15.
16.
Kwok MK, Schooling CM, Ho LM, Leung SSL, Mak KH, McGhee SM, Lam TH, Leung GM. Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong’s “children of 1997” birth cohort. Tob Control. 2008;17:263–70.CrossRefPubMed
17.
Boyle EM, Poulsen G, Field DJ, Kurinczuk JJ, Wolke D, Alfirevic Z, Quigley MA. Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study. BMJ. 2012;344:e896.CrossRefPubMedPubMedCentral
18.
Sun Y, Hsu P, Vestergaard M, Christensen J, Li J, Olsen J. Gestational age, birth weight, and risk for injuries in childhood. Epidemiology (Cambridge, Mass). 2010;21:650–7.CrossRef
19.
Paranjothy S, Dunstan F, Watkins WJ, Hyatt M, Demmler JC, Lyons RA, Fone D. Gestational age, birth weight, and risk of respiratory hospital admission in childhood. Pediatrics. 2013;132:e1562–9.CrossRefPubMed
20.
Slimings C, Einarsdottir K, Srinivasjois R, Leonard H. Hospital admissions and gestational age at birth: 18 years of follow up in Western Australia. Paediatr Perinat Epidemiol. 2014;28:536–44.CrossRefPubMed
21.
Petrou S, Kupek E, Hockley C, Goldacre M. Social class inequalities in childhood mortality and morbidity in an English population. Paediatr Perinat Epidemiol. 2006;20:14–23.CrossRefPubMed
22.
Norwegian Ministry of Health and Care Services. National strategy to reduce social inequalities in health. Report No. 20 (2006–2007) to the Storting. Norwegian Ministry of Health and Care Services; 2007.
23.
Fatttore G, Numerato D, Peltola M, Banks H, Graziani R, Heijink R, Over E, Klitkou ST, Fletcher E, Mihalicza P, et al. Variations and determinants of mortality and length of stay of very low birth weight and very low for gestational age infants in seven European countries. Health Econ. 2015;24:65–87.CrossRefPubMed
24.
Numerato D, Fattore G, Tediosi F, Zanini R, Peltola M, Banks H, Mihalicza P, Lehtonen L, Svereus S, Heijink R, et al. Mortality and length of stay of very low birth weight and very preterm infants: a EuroHOPE study. PLoS One. 2015;10:e0131685.CrossRefPubMedPubMedCentral
25.
Skjaerven R, Gjessing HK, Bakketeig LS. Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand. 2000;79:440–9.CrossRefPubMed
26.
McCrary J, Royer H. The effect of female education on fertility and infant health: evidence from school entry policies using exact date of birth. Am Econ Rev. 2011;101(1):158–95.CrossRefPubMedPubMedCentral
27.
28.
Kirkwood BR, Sterne JAC. Essential medical statistics. 2nd ed. Malden: Blackwell; 2003.
29.
Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, Wood AM, Carpenter JR. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.CrossRefPubMedPubMedCentral
30.
Moen A, Uleberg B, Olsen F, Steindal AH, Otterdal P, Deraas T, Magnus T, Balteskard L. [Atlas of Children’s Health in Norway] Barnehelseatlas for Norge. Tromsø: Center for Clinical Documentation and Evaluation (SKDE). 2015.
31.
Norwegian Research Council. [Limits for the treatment of preterm infants.] Grenser for behandling av for tidlig fødte barn. Konsensuskonferanse. Oslo: Norges forskningsråd. 1999; 13.
32.
Iversen T, Kopperud GS. Regulation versus practice — the impact of accessibility on the use of specialist health care in Norway. Health Econ. 2005;14:1231–8.CrossRefPubMed
33.
Finnvold JE. Access to specialized health care for asthmatic children in Norway: the significance of parents' educational background and social network. Soc Sci Med. 2006;63:1316–27.CrossRefPubMed
Metadata
Title
Use of hospital-based health care services among children aged 1 through 9 years who were born very preterm - a population-based study
Authors
Søren T. Klitkou
Tor Iversen
Hans J. Stensvold
Arild Rønnestad
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2498-3

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