Citation

Gnanamanickam ES, Brown DS, Armfield JM, Segal L. Prev. Med. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.ypmed.2022.107378

PMID

36493867

Abstract

Child maltreatment is a serious public health issue across the globe, with documented impacts on health, but the impact on hospital costs, at the population level, is unknown. We aimed to estimate the additional public hospital costs for emergency department visits and admitted patient hospitalizations, for persons with reported child protection concerns, from birth to 31 years and modelled to age 65. Using linked hospital data from 2003 to 2017 for a population birth-cohort of all individuals born in South Australia from 1986 to 2017, we estimated costs of public hospital care. Mean cost and cost differences (adjusted and unadjusted) in 2018 Australian dollars (AU$) were calculated for persons with child protection contact vs none, per person and at the population level. Persons with child protection contact had higher mean annual hospital costs than those with no contact, with cost differential increasing by age. Unadjusted differential cost per person was AU$338 (95% CI AU$204-AU$473) from birth to 12 years; increasing to AU$2242 (AU$2074-AU$2411) at ages 25 to 31 years, equating to an additional AU$124 (US$101) million for public hospital services from birth to 31 years, an 18% cost penalty (28% from 13 to 31 years). Modelled to age 65 years, excess costs were estimated at AU$415 (US$113, Adjusted: AU$365 and US$296) million, a 27% cost impost. There is a considerable hospital cost penalty associated with persons with reported child protection concerns, especially from adolescence into adulthood, highlighting an opportunity for cost savings by preventive investment in effective early-in-life interventions.

Language: en

Keywords

Costs; Prevention; Child maltreatment; Birth-cohort; Emergency visits; Hospitalizations