Youth and Young Adults With Cerebral Palsy: Their Use of Physician and Hospital Services

Abstract

Young NL, Gilbert TK, McCormick A, Ayling-Campos A, Boydell K, Law M, Fehlings DL, Mukherjee S, Wedge JH, Williams JI. Youth and young adults with cerebral palsy: their use of physician and hospital services.

Objectives

To examine patterns of health care utilization among youth and young adults who have cerebral palsy (CP) and to provide information to guide the development of health services for adults who have CP.

Design

This study analyzed health insurance data for outpatient physician visits and hospital admissions for a 4-year period.

Setting

Six children’s treatment centers in Ontario, Canada.

Participants

The sample included 587 youth and 477 adults with CP identified from health records. Youths were 13 to 17 years of age, and adults were 23 to 32 years of age at the end of the data range.

Interventions

Not applicable.

Main Outcome Measures

We computed the annual rates of outpatient physician visits and hospitalizations per 1000 persons and compared these with rates for the general population.

Results

Annual rates of outpatient physician visits were 6052 for youth and 6404 for adults with CP, 2.2 times and 1.9 times higher, respectively, than rates for age-matched peers (P<.01). Specialists provided 28.4% of youth visits but only 18.8% of adult visits. Annual hospital admission rates were 180 for youth and 98 for adults with CP, 4.3 times and 10.6 times higher, respectively, than rates for age-matched peers (P<.01).

Conclusions

It appears that youth and adults with CP continue to have complex care needs and rely heavily on the health care system. Comprehensive services are essential to support their health as they move into youth and adulthood. However, there appear to be gaps in the adult health care system, such as limited access to specialist physicians.

Key Words: Cerebral palsy, Health services, Health transition, Rehabilitation

a School of Human Kinetics, Laurentian University, Sudbury, ON, Canada

b Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada

c Surgery, The Hospital for Sick Children, Toronto, ON, Canada

d Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

e Ottawa Children’s Treatment Centre and The Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

f School of Occupational Therapy, McMaster University, Hamilton, ON, Canada

g Bloorview Kids Rehab, Toronto, ON, Canada

h The Rehabilitation Institute of Chicago, Chicago, IL.

Reprint requests to Nancy L. Young, PhD, Laurentian University, 935 Ramsey Lake Rd, Sudbury, ON P3E 2C6, Canada

Supported by the Bloorview Children’s Hospital Foundation, the Canadian Institutes for Health Research (CIHR), and a Canada Research Chair in Rural and Northern Children’s Health from CIHR.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)00198-0

doi:10.1016/j.apmr.2007.03.005

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