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Costs for physical and mental health hospitalizations in the first 13 years of life among children engaged with Child Protection Services


Neil, AL and Islam, F and Kariuki, M and Laurens, KR and Katz, I and Harris, F and Carr, VJ and Green, MJ, Costs for physical and mental health hospitalizations in the first 13 years of life among children engaged with Child Protection Services, Child Abuse & Neglect, 99 Article 104280. ISSN 0145-2134 (2020) [Refereed Article]


Copyright Statement

Copyright 2019 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

DOI: doi:10.1016/j.chiabu.2019.104280


Background: Longitudinal data on health costs associated with physical and mental conditions are not available for children reported to child protection services.

Objective: To estimate the costs of hospitalization for physical and mental health conditions by child protection status, including out-of-home-care (OOHC) placement, from birth until 13-years, and to assess the excess costs associated with child protection contact over this period.

Participants and Setting: Australian population cohort of 79,285 children in a multi-agency linkage study.

Methods: Costs of hospitalization were estimated from birth (if available) using Round 17, National Hospital Cost Data Collection (2012-13; deflated to 2015-16 AUD). Records of the state child protection authority determined contact status. Data were reported separately for children in OOHC. Hospital separations were classified as mental disorder-related if the primary diagnosis was recorded in ICD-10 Chapter V (F00-F99).

Results: Hospital separations were more common in children with child protection contact. Physical health care costs per child decreased with age for all children, but were significantly higher for children with contact. Mental health costs per child were always significantly higher for children with contact, with marked increases at 3 ≤ 4 years and 8 ≤ 9 years. Point estimates of annual costs per child were always highest for children with an OOHC placement. The net present value of the excess costs was $3,224 per child until 13- years, discounted at 5 %.

Conclusions: Children in contact with child protection services show higher rates and costs for physical and mental health hospitalizations in each of their first 13 years of life.

Item Details

Item Type:Refereed Article
Keywords:child protection contact, excess costs, hospitalizations, mental health, multi-agency data linkage, physical health, short-term costs
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Neonatal and child health
UTAS Author:Neil, AL (Associate Professor Amanda Neil)
ID Code:136071
Year Published:2020
Funding Support:National Health and Medical Research Council (1133833)
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-11-28
Last Modified:2021-03-25
Downloads:18 View Download Statistics

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