[Health care utilization of intercountry adopted children. A Danish follow-up study].
BACKGROUND
Children adopted from developing countries have suffered from infectious diseases, malnutrition, growth and psychomotor retardation on arrival to adopting families. Aims were to investigate the degree of health care utilization among intercountry adoptees and to assess whether health care utilization was higher than for non-adoptees.


METHODS
A historical follow-up study of a cohort of children intercountry adopted to the County of North Jutland in Denmark from 1995-1998 and a group of controls. Adoption was exposure and health care utilization was outcome. Data about hospitalization and selected ICD-10 diagnosis were ascertained from The Danish National Health Register and data about use of general practitioners (GPs) and specialists were ascertained from The National Health Insurance Service Registry. Relative risk (RR) of hospitalization and use of specialists was estimated. Average use of GPs was calculated.


RESULTS
The risk of hospitalization and contact to specialists was 61% and 43% higher for adoptees compared to non-adoptees. Adoptees had a 10% increased average use of GPs the first year after arrival whereas there were no differences in the total average use of GPs. The risk of being discharged from hospital with a diagnosis within the ICD-10 diagnose group of congenital malformation and deformation was increased (RR: 3.0).


CONCLUSIONS
Intercountry adopted children had an increased risk of health care utilization and an increased average use of health services. Further investigation is required in order to obtain information about the type of utilization.
Fock
Lotte
L
Sundheds CVU Nordjylland, University College, Viden- og udviklingscentret, i samarbejde med Forskningsenhed for Klinisk Sygepleje, Aalborg Sygehus, Aalborg Ø. lotte.fock@scvun.dk
D000300:Adoption; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000208:ethnology; D003718:Denmark / Q000453:epidemiology / Q000208:ethnology; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D010272:Parasitic Diseases / Q000453:epidemiology / Q000208:ethnology; D010343:Patient Admission / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D014600:Utilization Review