Talarico Fernanda, Metes Dan, Wang Mengzhe, Hayward Jake, Liu Yang S, Tian Julie, Zhang Yanbo, Greenshaw Andrew J, Gaskin Ashley, Janus Magdalena, Cao Bo
Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Government of Alberta, Ministry of Health, Edmonton, Alberta, Canada.
PLOS Digit Health. 2024 Sep 17;3(9):e0000611. doi: 10.1371/journal.pdig.0000611. eCollection 2024 Sep.
In the context of the COVID-19 pandemic, it becomes important to comprehend service utilization patterns and evaluate disparities in mental health-related service access among children.
This study uses administrative health records to investigate the association between early developmental vulnerability and healthcare utilization among children in Alberta, Canada from 2016 to 2022.
Children who participated in the 2016 Early Development Instrument (EDI) assessment and were covered by public Alberta health insurance were included (N = 23 494). Linear regression models were employed to investigate the association between service utilization and vulnerability and biological sex. Separate models were used to assess vulnerability specific to each developmental domain and vulnerability across multiple domains. The service utilization was compared between pre- and post-pandemic onset periods.
The analysis reveals a significant decrease in all health services utilization from 2016 to 2019, followed by an increase until 2022. Vulnerable children had, on average, more events than non-vulnerable children. There was a consistent linear increase in mental health-related utilization from 2016 to 2022, with male children consistently experiencing higher utilization rates than females, particularly among vulnerable children. Specifically, there was a consistent linear increase in the utilization of anxiety-related services by children from 2016 to 2022, with females having, on average, 25 more events than males. The utilization of ADHD-related services showed different patterns for each group, with vulnerable male children having more utilization than their peers.
Utilizing population-wide data, our study reveals sex specific developmental vulnerabilities and its impact on children's mental health service utilization during the COVID-19 pandemic, contributing to the existing literature. With data from kindergarten, we emphasize the need for early and targeted intervention strategies, especially for at-risk children, offering a path to reduce the burden of childhood mental health disorders.
在新冠疫情背景下，了解儿童的服务利用模式并评估心理健康相关服务获取方面的差异变得至关重要。
本研究利用行政健康记录，调查2016年至2022年加拿大艾伯塔省儿童早期发育脆弱性与医疗保健利用之间的关联。
纳入参加2016年早期发展工具（EDI）评估且有艾伯塔省公共医疗保险覆盖的儿童（N = 23494）。采用线性回归模型研究服务利用与脆弱性及生物学性别之间的关联。使用单独的模型评估每个发育领域特有的脆弱性以及多个领域的脆弱性。比较疫情爆发前和后时期的服务利用情况。
分析显示，2016年至2019年所有健康服务利用显著下降，随后至2022年有所增加。脆弱儿童平均比非脆弱儿童有更多的就诊情况。2016年至2022年心理健康相关利用呈持续线性增长，男童的利用率始终高于女童，尤其是在脆弱儿童中。具体而言，2016年至2022年儿童焦虑相关服务的利用呈持续线性增长，女性平均比男性多25次就诊情况。注意力缺陷多动障碍（ADHD）相关服务的利用在每组中呈现不同模式，脆弱男童的利用率高于同龄人。
利用全人群数据，我们的研究揭示了特定性别的发育脆弱性及其在新冠疫情期间对儿童心理健康服务利用的影响，为现有文献做出了贡献。基于幼儿园数据，我们强调需要早期和有针对性的干预策略，特别是针对高危儿童，为减轻儿童心理健康障碍负担提供了一条途径。
