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Associations between parental mental health and other family factors and healthcare utilisation among children and young people: a retrospective, cross-sectional study of linked healthcare data
  1. Kathryn Dreyer1,
  2. Robert A P Williamson1,
  3. Dougal S Hargreaves2,
  4. Rebecca Rosen3,
  5. Sarah R Deeny1
  1. 1 Data Analytics, The Health Foundation, London, UK
  2. 2 UCL Great Ormond Street Institute of Child Health, London, UK
  3. 3 Valentine Health, London, UK
  1. Correspondence to Ms Kathryn Dreyer; kathryn.dreyer{at}health.org.uk

Abstract

Objective To identify the degree to which parental diagnosis of depression or other long-term conditions, parental health-seeking behaviours and household factors were associated with a healthcare utilisation among children and young people (CYP) (0–15 years).

Design Retrospective, cross-sectional study of electronic health records, from 25 252 patients registered at a large, London-based primary care provider. The associations between children’s healthcare utilisation and the characteristics of the child, their parents/carers and their household structure were examined using multivariable regression.

Results Controlling for parental utilisation, parental depression (vs not) was significantly associated with increased healthcare utilisation for CYP. Odds ratios for CYP with siblings=1.41 (95% CI 1.10 to 1.80) for emergency department (ED) attendances, 1.67 (95% CI 1.32 to 2.11) for outpatient appointments, 1.47 (95% CI 1.07 to 2.03) for inpatient admission, and rate rato=1.28 (95% CI 1.04 to 1.78) for general practitioner (GP) consultations.

After adjusting for child and parental characteristics, parental general practice attendance (+1 from mean) was predictive of increased CYP general practice attendance, rate ratio 1.07 (95% CI 1.06 to 1.08) for CYP with siblings. Parental ED attendance also increased the risk of CYP ED attendance, with OR 1.27 (95% CI 1.12 to 1.44) for CYP with siblings.

Conclusions Parental depression is associated with increased utilisation of ED, outpatient and inpatient services by CYP, as well as with increased GP consultations among adolescents. Our results demonstrate that healthcare utilisation by CYP is associated with the health-seeking behaviour of adults in their household.

  • adolescent health
  • data collection

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors SRD and RAPW conceived the study. SRD and RAPW designed the statistical analysis plan. RR prepared the data extract. KD and RAPW carried out the analysis. All authors drafted and finalised the paper.

  • Funding This study was funded as part of the core activities of the Health Foundation. The corresponding author had full access to all data in the study and final responsibility for the decision to submit.

  • Disclaimer The funding body had no role in the design of the study; collection, analysis or interpretation of data; writing the manuscript; or decision to submit.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study meets national guidelines set out by the Research Ethics Service for the National Health Service in England.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data that support the findings of this study are available from Valentine Health but restrictions apply to the availability of these data, which were used under a data sharing agreement for the current study, and so are not publicly available. Data are, however, available from the authors on reasonable request and with permission of Valentine Health.

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