Abstract
Objective
To systematically review and synthesize evidence of determinants associated with hospital-based
health service utilization among individuals with cerebral palsy (CP).
Data Sources
Electronic databases MEDLINE, Embase, APA Psycinfo were searched from January 2000
to April 2020.
Study Selection
Observational studies were included that described people with CP, reported quantitative
measures of hospital-based health service utilization (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 utilization.
Data Extraction
After initial screen, 2 reviewers reviewed full texts for inclusion and performed
data extraction and risk of bias assessment using the Newcastle-Ottawa scale. Determinants
of health service utilization were identified and categorized using the Andersen behavioral
model.
Data Synthesis
Seventeen studies met inclusion criteria. Study quality was high. Twenty-six determinants
were reported across 8 Andersen model characteristics. Individual predisposing factors
such as sex showed no difference in health service utilization; inpatient admissions
decreased with increasing age during childhood and was lower in adults. Increased
health service utilization 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 determinants.
Conclusions
CP health service utilization is associated with age, severity and comorbidities.
Improved understanding of determinants of health service utilization can support health
service access for people with CP.
Keywords
List of abbreviations:
CP (cerebral palsy), GMFCS (Gross Motor Function Classification System), IRR (incident rate ratio), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 27, 2021
Accepted:
December 1,
2021
Received in revised form:
October 25,
2021
Received:
July 29,
2021
Footnotes
S.P. was supported by a career development grant from the Cerebral Palsy Alliance Research Foundation career development grant (CDG03018) and a Royal Australasian College of Physicians Australasian Faculty of Rehabilitation Medicine Research Entry Scholarship. N.N. was supported by the Financial Markets Foundation for Children and Australian National Health and Medical Research Council Investigator Grant (APP1197940).
Disclosures: none.
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine.
