To systematically review and synthesize evidence of determinants associated with hospital-based
health service utilisation among individuals with cerebral palsy (CP).
Electronic databases MEDLINE, Embase, APA Psycinfo were searched from January 2000
to April 2020.
Observational studies were included that described people with CP, reported quantitative
measures of hospital-based health service utilisation (inpatient, outpatient, emergency
department), and based in high-income countries. We excluded studies that included
only subsets of people with CP, or those that only reported therapy service utilisation.
After initial screen, two reviewers reviewed full texts for inclusion and performed
data extraction and risk of bias assessment using the Newcastle Ottawa scale. Determinants
of health service utilisation were identified and categorised using the Andersen Behavioural
Seventeen studies met inclusion criteria. Study quality was high. Twenty-six determinants
were reported across eight Andersen Model characteristics. Individual predisposing
factors such as sex showed no difference in health service utilisation; inpatient
admissions decreased with increasing age during childhood and was lower in adults.
Increased health service utilisation was associated with “individual need” including
severe gross motor disability, epilepsy, developmental/ intellectual disability and
gastrostomy-use across inpatient, outpatient and emergency department settings. There
was little information reported on socio-demographic and health system contextual
CP health service utilisation was associated with age, severity and comorbidities.
Improved understanding of determinants of health service utilisation can support health
service access for people with CP.