Sciberras Emma, Westrupp Elizabeth M, Wake Melissa, Nicholson Jan M, Lucas Nina, Mensah Fiona, Gold Lisa, Reilly Sheena
Murdoch Childrens Research Institute , Melbourne , Australia.
Int J Speech Lang Pathol. 2015 Feb;17(1):41-52. doi: 10.3109/17549507.2014.898095. Epub 2014 May 6.
This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative samples of children.
Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years; K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme.
It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311; p = .002) for each additional wave of language difficulties.
Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.
本研究旨在量化两个具有全国代表性的儿童样本中与语言困难相关的非医院医疗保健成本。
数据来自澳大利亚儿童纵向研究的三个两年期波次(2004 - 2008年)(B队列:0 - 5岁;K队列:4 - 9岁)。语言困难定义为在家长报告的沟通测量(0 - 3岁)和直接评估的词汇量(4 - 9岁)方面得分低于均值1.25个标准差。参与者数据与来自澳大利亚全民医疗保险补贴医疗保健计划的非医院医疗保健就诊和处方药行政数据相关联。
研究发现,在0 - 1岁、2 - 3岁和4 - 5岁时,有语言困难的儿童每2年年龄组的医疗保健成本高于无语言困难的儿童,在4 - 5岁时(B队列)显著高出36%(平均差异 = 206澳元,95%置信区间 = 90澳元,321澳元)。6 - 7岁和8 - 9岁有语言困难的儿童略高的2年医疗保健成本与无语言困难的儿童无统计学差异。根据相应的澳大利亚儿童人口进行建模,2年政府成本在120万澳元至1210万澳元之间(取决于所研究的年龄)。在K队列中,6年医疗保健成本随着语言困难的持续存在而增加,每增加一波语言困难,医疗保险总成本增加192澳元(95%置信区间 = 74澳元,311澳元;p = 0.002)。
语言困难(无论是短暂的还是持续的)与儿童时期大量额外的人群医疗保健成本相关,这是除了通过教育系统产生的已知更广泛成本之外的。尚不清楚医疗保健成本是否具体归因于语言困难的评估和/或治疗,而不是可能与语言困难共病或可能导致语言困难 的病症。