Neil, AL and Chappell, K and Wagg, F and Miller, A and Judd, F, The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle, Social Science and Medicine, 284 pp. 1-9. ISSN 0277-9536 (2021) [Refereed Article]
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Background: Tasmania, Australia has a small widely dispersed regional and rural population. The Conception to Community (C2C) Study Database was established as a research platform to inform service planning and policy development and improve health outcomes for Tasmanian mothers and children. The aims of this study were to establish by maternal socio-demographic characteristics: 1) the distribution of births in Tasmania; 2) hospital utilisation for children from birth to 5-years; and 3) the association between child and maternal emergency department (ED) presentation rates.
Methods: Perinatal and public hospital ED and admitted patient data were linked for every child born in Tasmania between 2008-09 to 2013-14, and their mothers. Individualised rates of ED presentations and hospital admissions were calculated from birth to 5-years. Frequent presenters to ED were defined as having at least four presentations per annum. Ratios of ED presentation and hospital admission rates by sociodemographic characteristics (region (north, north-west, south), rurality, maternal age, and area socioeconomic disadvantage) were estimated using mixed-effects negative binomial models, with random intercepts for each child and family.
Results: The C2C Database is comprised of records for 37,041 children and 27,532 mothers. One-in-ten Tasmanian babies lived in a remote area. The mean yearly rate of ED presentations per child varied by sex, age, region and rurality. Frequent presenters were more likely to reside in the north-west or north, in urban areas, have mothers under 20- years, be male, and live in more disadvantaged areas, with 2.3% of children frequent presenters in their first year of life. The odds of a child being a frequent presenter during their first-year was 6.1- times higher if the mother was a frequent presenter during this period.
Conclusion: Associations between maternal and child health service use and combined effects of regionality and rurality highlight opportunities for targeted intervention and service innovations.
|Item Type:||Refereed Article|
|Keywords:||child health, emergency department, health service utilisation, linked data analysis, maternal health, rural and regional|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Rural clinical health|
|Objective Group:||Specific population health (excl. Indigenous health)|
|Objective Field:||Rural and remote area health|
|UTAS Author:||Neil, AL (Associate Professor Amanda Neil)|
|UTAS Author:||Chappell, K (Ms Katherine Chappell)|
|UTAS Author:||Miller, A (Ms April Miller)|
|UTAS Author:||Judd, F (Professor Fiona Judd)|
|Deposited By:||Menzies Institute for Medical Research|
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