Wenjia Chen1,2, Padmaja Subbarao3,4,5, Rachel E McGihon1, Laura Y Feldman1, Jingqin Zhu1,2, Wendy Lou6, Andrea S Gershon1,2,6,7, Kawsari Abdullah1, Theo J Moraes3,4, Aimée Dubeau3, Malcolm R Sears5, Diana L Lefebvre5, Stuart E Turvey8, Piush J Mandhane9, Meghan B Azad10, Teresa To1,2,6. 1. Child Health Evaluative Sciences Program, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. 2. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 3. Translational Medicine and Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. 4. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 5. Department of Medicine, McMaster University, Hamilton, Ontario, Canada. 6. Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 7. Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 8. Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 9. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. 10. Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
OBJECTIVES: To identify distinctive patterns of respiratory-related health services use (HSU) between birth and 3 years of age, and to examine associated symptom and risk profiles. METHODS: This study included 729 mother and child pairs enrolled in the Toronto site of the Canadian Healthy Infant Longitudinal Development study in 2009-2012; they were linked to Ontario health administrative databases (2009-2016). A model-based cluster analysis was performed to identify distinct groups of children who followed a similar pattern of respiratory-related HSU between birth and 3 years of age, regarding hospitalization, emergency department (ED) and physician office visits for respiratory conditions and total health care costs (2016 Canadian dollars). RESULTS: The majority (estimated cluster weight = 0.905) showed a pattern of low and stable respiratory care use (low HSU) while the remainder (weight = 0.095) showed a pattern of high use (high HSU). From 0 to 3 years of age, the low- and high-HSU groups differed in mean trajectories of total health care costs ($783 per 6 months decreased to $114, vs $1796 to $177, respectively). Compared to low-HSU, the high-HSU group was associated with a constant risk of hospitalizations, early high ED utilization and physician visits for respiratory problems. The two groups differed significantly in the timing of wheezing (late onset in low-HSU vs early in high-HSU) and future total costs (stable vs increased). CONCLUSIONS: One in ten children had high respiratory care use in early life. Such information can help identify high-risk young children in a large population, monitor their long-term health, and inform resource allocation.
OBJECTIVES: To identify distinctive patterns of respiratory-related health services use (HSU) between birth and 3 years of age, and to examine associated symptom and risk profiles. METHODS: This study included 729 mother and child pairs enrolled in the Toronto site of the Canadian Healthy Infant Longitudinal Development study in 2009-2012; they were linked to Ontario health administrative databases (2009-2016). A model-based cluster analysis was performed to identify distinct groups of children who followed a similar pattern of respiratory-related HSU between birth and 3 years of age, regarding hospitalization, emergency department (ED) and physician office visits for respiratory conditions and total health care costs (2016 Canadian dollars). RESULTS: The majority (estimated cluster weight = 0.905) showed a pattern of low and stable respiratory care use (low HSU) while the remainder (weight = 0.095) showed a pattern of high use (high HSU). From 0 to 3 years of age, the low- and high-HSU groups differed in mean trajectories of total health care costs ($783 per 6 months decreased to $114, vs $1796 to $177, respectively). Compared to low-HSU, the high-HSU group was associated with a constant risk of hospitalizations, early high ED utilization and physician visits for respiratory problems. The two groups differed significantly in the timing of wheezing (late onset in low-HSU vs early in high-HSU) and future total costs (stable vs increased). CONCLUSIONS: One in ten children had high respiratory care use in early life. Such information can help identify high-risk young children in a large population, monitor their long-term health, and inform resource allocation.
Authors: Emma S Campisi; Myrtha E Reyna; May Brydges; Aimee Dubeau; Theo J Moraes; Paolo Campisi; Padmaja Subbarao Journal: Eur Arch Otorhinolaryngol Date: 2021-09-20 Impact factor: 2.503
Authors: Kawsari Abdullah; Deshayne B Fell; Dhenuka Radhakrishnan; Steven Hawken; David W Johnson; Piush Mandhane; Teresa To; Gary Joubert; Amy C Plint Journal: BMJ Open Date: 2021-05-03 Impact factor: 2.692
Authors: Andrew McDavid; Nathan Laniewski; Alex Grier; Ann L Gill; Haeja A Kessler; Heidie Huyck; Elizabeth Carbonell; Jeanne Holden-Wiltse; Sanjukta Bandyopadhyay; Jennifer Carnahan; Andrew M Dylag; David J Topham; Ann R Falsey; Mary T Caserta; Gloria S Pryhuber; Steven R Gill; Kristin M Scheible Journal: iScience Date: 2022-03-01
Authors: Konstantinos Poulakis; Joana B Pereira; J-Sebastian Muehlboeck; Lars-Olof Wahlund; Örjan Smedby; Giovanni Volpe; Colin L Masters; David Ames; Yoshiki Niimi; Takeshi Iwatsubo; Daniel Ferreira; Eric Westman Journal: Nat Commun Date: 2022-08-05 Impact factor: 17.694