August 6, 2019

High rates of healthcare utilization in children with multiple sclerosis in Canada

SUMMARY: This study set out to understand health care utilization of children with pediatric-onset multiple sclerosis (MS) in Canada using population level data. Health care utilization is driven by predisposing factors (e.g. such as age), factors that influence access to services (e.g. transportation, region, socioeconomic status), and the need for services (i.e. symptoms, illness). Researchers examined health care utilization of youth with and without MS in Ontario using population-based data and found that children with MS have substantially elevated rates of health care utilization, particularly in the year of diagnosis, and it remains elevated as compared to children without MS.

BACKGROUND: Adults affected by MS have higher rates of healthcare utilization as compared to adults without MS. With the advent of disease modifying therapies, hospitalization rates in the adult population have decreased significantly over the last twenty years. However, little is known about health care utilization in the pediatric population in Canada. While pediatric MS has higher relapse rates than adults, their recovery from physical impairments can be greater than in adults with MS. Children experience cognitive and behavioural impairments that can develop earlier, and their health can be influenced by parental factors.

STUDY: This population-based study utilized healthcare administrative data from 3,943 youth (659 youth living with MS and 3,294 youth without MS) to understand health care utilization, including any hospitalizations and physician visits between 2003-2014.

RESULTS: From this study, the researchers found health care utilization overall was higher in the pediatric population with MS as compared to those without MS. Male youth with MS had lower likelihood of hospitalization and lower rates of physician visits than female youth. Age was associated with an increased likelihood of hospitalization and higher rates of physician visits. Visits to psychiatry, ophthalmology and physiatry were more frequent for youth with MS. Health care utilization was elevated in the year of diagnosis, particularly for hospitalizations. Health care utilization declined following diagnosis, but remained elevated as compared to children without MS.

IMPACT: This research evaluates health care utilization and the impact of pediatric MS on the health system. The outcomes of this research can be used to better predict future health system needs and to evaluate the cost-benefit of treatment strategies with the ultimate goal of optimizing patient care and health outcomes.

Research study is published in PLOS ONE – link.