Medical, social, and economic factors associated with health-related quality of life in Canadian children with hydrocephalus.
OBJECTIVE
To study the factors associated with health-related quality of life (HRQL) in Canadian children with hydrocephalus, using a comprehensive model of determinants of child health, including socioeconomic factors.


METHODS
A cross-sectional study was performed between November 2005 and November 2006 at 3 Canadian pediatric hospitals. Parents of children with hydrocephalus age 5 to 18 years completed the Hydrocephalus Outcome Questionnaire (HOQ) and the Health Utilities Index Mark 3 (HUI-3).


RESULTS
A consecutive sample of 340 subjects participated from a total of 366 eligible children (mean age, 11.6 +/- 3.6 years; mean time from the diagnosis of hydrocephalus, 10.0 +/- 4.6 years). Adjusted multivariate linear regression models demonstrated that the most important determinants of poorer HRQL included lower family income, lower parental education, worse family functioning, seizures, myelomeningocele, and prolonged treatment for cerebrospinal fluid shunt obstruction.


CONCLUSIONS
Despite a national universal health care system, socioeconomic disparities remain important as determinants of HRQL. Given the absence of a parallel private health care system in Canada, this suggests that the impact of socioeconomic factors is related to issues other than access to care.
Division of Child Health and Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. abhaya.kulkarni@sickkids.ca
Abhaya V
AV
Kulkarni
D Douglas
DD
Cochrane
P Daniel
PD
McNeely
Iffat
I
Shams
D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D011788:Quality of Life; D012044:Regression Analysis; D012107:Research Design; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires