title: Use of health care among adults with chronic and complex physical disabilities of childhood.
abstract: The purpose of this study was to explore the patterns of health services utilization among adults with chronic and complex physical disabilities of childhood, specifically cerebral palsy, spina bifida, and acquired brain injuries.METHODS. A cohort of 345 young adults who had graduated from the Bloorview MacMillan Children's Centre was identified. Their health care records were extracted from Ontario Health Insurance Plan (OHIP) and Canadian Institute for Health Information (CIHI) databases, for a four-year period. These data were analysed to estimate the frequency of out-patient physician visits and admissions to hospital.RESULTS. The mean age of the sample was 21.9 years (range 19.0-26.9 years). The results show that 95% of the sample visited a physician at least once per year, and 24% had a primary care physician. On average, these adults visited physicians 11.5 times per year (approximately once per month) and were admitted to hospital once every 6.8 years.CONCLUSIONS. These results suggest that adults with complex physical disabling conditions from childhood have ongoing health issues that require frequent service. Their admission rate is 9.0 times that of the general population, and few have a primary care physician. A new model of service may be necessary for this high-needs group.
authors.affiliation: The Hospital for Sick Children, Toronto, Canada. nancy.young@sickkids.ca
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Young
authors.forename: Catherine
authors.initials: C
authors.lastname: Steele
authors.forename: Darcy
authors.initials: D
authors.lastname: Fehlings
authors.forename: Jeffery
authors.initials: J
authors.lastname: Jutai
authors.forename: Nancy
authors.initials: N
authors.lastname: Olmsted
authors.forename: J Ivan
authors.initials: JI
authors.lastname: Williams
mesh_terms: D000328:Adult; D020208:Brain Injury, Chronic / Q000534:rehabilitation*; D002547:Cerebral Palsy / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009864:Ontario; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000534:rehabilitation*