Impact of functional somatic symptoms on 5–7-year-olds' healthcare use and costs

• Published in: Archives of disease in childhood 2017-07, Vol.102 (7), p.00-623
• Main Authors: Græsholt-Knudsen, Troels, Skovgaard, Anne Mette, Jensen, Jens Søndergaard, Rask, Charlotte Ulrikka
• Format: Article
• Language: English
• Subjects: Age; Attrition (Research Studies); Child; Child Health Services - economics; Child Health Services - utilization; Child, Preschool; Children; Children & youth; Chronic Disease; Classification; Clinical significance; Company business management; Consumer Price Index; Costs and Cost Analysis; Denmark - epidemiology; Epidemiology; Families & family life; Family Income; Female; Health aspects; Health care; Health problems; Health Services; Humans; Laboratories; Male; Management; Medical care; Medical care (Private); Mental Disorders; Neurodevelopmental Disorders - economics; Neurodevelopmental Disorders - therapy; Observational studies; Parents; Parents & parenting; Patient Acceptance of Health Care - statistics & numerical data; Pediatrics; Physical Health; Population; Population Education; Prediction models; Primary care; Primary Health Care - economics; Primary Health Care - utilization; Prospective Studies; Psychopathology; Regression analysis; Socioeconomic Factors; Somatoform Disorders - economics; Somatoform Disorders - epidemiology; Somatoform Disorders - therapy; Tax services; Variables; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2016-311808

ObjectiveKnowledge 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.DesignAt 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.Results1018 (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).ConclusionsImpairing 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.