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Youth and young adults with spina bifida: their utilization of physician and hospital services

Young NL, Anselmo LA, Burke TA, McCormick A, Mukherjee S. Arch Phys Med Rehabil. 2014; 95(3):466-71. Epub 2013 Oct 4.

Objective — To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population.

Design — We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes.

Setting — Participants were identified from 6 publicly funded children's treatment centers.

Participants — Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study.

Interventions — Not applicable.

Main Outcome Measures — The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated.

Results — The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population.

Conclusions — It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care.

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Keywords: Neurological disorders Health care utilization Adolescent health