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Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London

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Title: Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London
Authors: Beaney, T
Clarke, J
Woodcock, T
McCarthy, R
Saravanakumar, K
Barahona, M
Blair, M
Hargreaves, D
Item Type: Journal Article
Abstract: Objectives With a growing role for health services in managing population health, there is a need for early identification of populations with high need. Segmentation approaches partition the population based on demographics, long-term conditions (LTCs) or healthcare utilisation but have mostly been applied to adults. Our study uses segmentation methods to distinguish patterns of healthcare utilisation in children and young people (CYP) and to explore predictors of segment membership. Design Retrospective cohort study. Setting Routinely collected primary and secondary healthcare data in Northwest London from the Discover database. Participants 378,309 CYP aged 0-15 years registered to a general practice in Northwest London with one full year of follow-up. Primary and secondary outcome measures Assignment of each participant to a segment defined by seven healthcare variables representing primary and secondary care attendances, and description of utilisation patterns by segment. Predictors of segment membership described by age, sex, ethnicity, deprivation and LTCs. Results Participants were grouped into six segments based on healthcare utilisation. Three segments predominantly used primary care; two moderate utilisation segments differed in use of emergency or elective care, and a high utilisation segment, representing 16,632 (4.4%) children accounted for the highest mean presentations across all service types. The two smallest segments, representing 13.3% of the population, accounted for 62.5% of total costs. Younger age, residence in areas of higher deprivation, and presence of one or more LTCs were associated with membership of higher utilisation segments, but 75.0% of those in the highest utilisation segment had no LTC. Conclusions This article identifies six segments of healthcare utilisation in CYP and predictors of segment membership. Demographics and LTCs may not explain utilisation patterns as strongly as in adults which may limit the use of routine data in predicting utilisation and suggests children have less well-defined trajectories of service use than adults.
Issue Date: 17-Dec-2021
Date of Acceptance: 24-Nov-2021
URI: http://hdl.handle.net/10044/1/93152
DOI: 10.1136/bmjopen-2021-050847
ISSN: 2044-6055
Publisher: BMJ Journals
Start Page: 1
End Page: 14
Journal / Book Title: BMJ Open
Volume: 11
Issue: 12
Copyright Statement: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: National Institute for Health Research Applied Research Collaboration North West London
Health Data Research Uk
Wellcome Trust
Engineering & Physical Science Research Council (EPSRC)
National Institute of Health and Medical Research
Funder's Grant Number: Health Data Research UK
UNS81609 - 215938/Z/19/Z
EP/N014529/1
NIHR200180
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
health informatics
health services administration & management
paediatrics
public health
statistics & research methods
health informatics
health services administration & management
paediatrics
public health
statistics & research methods
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status: Published
Online Publication Date: 2021-12-17
Appears in Collections:Mathematics
Applied Mathematics and Mathematical Physics
Faculty of Medicine
Institute of Global Health Innovation
School of Public Health
Faculty of Natural Sciences



This item is licensed under a Creative Commons License Creative Commons