Care use and its intensity in children with complex problems are related to varying child and family factors: A follow-up study

• Published in: PloS one Vol. 15; no. 5; p. e0231620
• Main Authors: Pannebakker, Noortje M, Kocken, Paul L, van Dommelen, Paula, van Mourik, Krista, Reis, Ria, Reijneveld, Sijmen A, Numans, Mattijs E
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.05.2020; Public Library of Science (PLoS)
• Subjects: Age; Beer; Biology and Life Sciences; Care and treatment; Child & adolescent psychiatry; Children; Children & youth; Children's services; Childrens health; Confidence intervals; Families & family life; Family; Family relations; Health care; Medicine and Health Sciences; Parenting; Parents & parenting; Pediatric research; People and Places; Primary care; Problem children; Psychological aspects; Public health; Questionnaires; Research and Analysis Methods; Social aspects; Social Sciences; Social support; Netherlands; Hague Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0231620

There is little evidence on the child and family factors that affect the intensity of care use by children with complex problems. We therefore wished to identify changes in these factors associated with changes in care service use and its intensity, for care use in general and psychosocial care in particular. Parents of 272 children with problems in several life domains completed questionnaires at baseline (response 69.1%) and after 12 months. Negative binominal Hurdle analyses enabled us to distinguish between using care services (yes/ no) and its intensity, i.e. number of contacts when using care. Change in care use was more likely if the burden of adverse life events (ALE) decreased (odds ratio, OR = 0.94, 95% confidence interval, CI = 0.90-0.99) and if parenting concerns increased (OR = 1.29, CI = 1.11-1.51). Psychosocial care use became more likely for school-age children (vs. pre-school) (OR = 1.99, CI = 1.09-3.63) if ALE decreased (OR = 0.93, CI = 0.89-0.97) and if parenting concerns increased (OR = 1.26, CI = 1.10-1.45). Intensity of use (>0 contacts) of any care decreased when ALE decreased (relative risk, RR = 0.95, CI = 0.92-0.98) and when psychosocial problems became less severe (RR = 0.38, CI = 0.20-0.73). Intensity of psychosocial care also decreased when severe psychosocial problems became less severe (RR = 0.39, CI = 0.18-0.84). Changes in care-service use (vs. no use) and its intensity (>0 contacts) are explained by background characteristics and changes in a child's problems. Care use is related to factors other than changes in its intensity, indicating that care use and its intensity have different drivers. ALE in particular contribute to intensity of any care use.