title: Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study.
abstract: OBJECTIVE
  We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non-hospital health-care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN.
  
  
  METHODS
  Data from the first two biennial waves of the nationally representative Longitudinal Study of Australian Children, comprising two independent cohorts recruited in 2004, at ages 0-1 (n = 5107) and 4-5 (n = 4983) years. Exposure condition: parent-reported Children with Special Health Care Needs Screener at both waves, spanning ages 0-7 years.
  
  
  METHODS
  Federal Government Medicare expenditure, via data linkage to the Medicare database, on non-hospital health-care attendances and prescriptions from birth to 8 years.
  
  
  RESULTS
  At both waves and in both cohorts, >92% of children had complete SHCN and Medicare data. The proportion of children with SHCN increased from 6.1% at age 0-1 years to 15.0% at age 6-7 years. Their additional Medicare costs ranged from $491 per child at 6-7 years to $1202 at 0-1 year. This equates to an additional $161.8 million annual cost or 0.8% of federal funding for non-hospital-based health care. In both cohorts, costs were highest for children with persistent SHCNs.
  
  
  CONCLUSIONS
  SHCNs incur substantial non-hospital costs to Medicare, and no doubt other sources of care, from early childhood. This suggests that economic evaluations of early prevention and intervention services for SHCNs should consider impacts on not only the child and family but also the health-care system.
authors.affiliation: Centre for Community Child Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Jon
authors.initials: J
authors.lastname: Quach
authors.forename: Frank
authors.initials: F
authors.lastname: Oberklaid
authors.forename: Lisa
authors.initials: L
authors.lastname: Gold
authors.forename: Nina
authors.initials: N
authors.lastname: Lucas
authors.forename: Fiona K
authors.initials: FK
authors.lastname: Mensah
authors.forename: Melissa
authors.initials: M
authors.lastname: Wake
mesh_terms: D000367:Age Factors; D001315:Australia; D002648:Child; D002654:Child Care / Q000191:economics*; D002662:Child Health Services / Q000191:economics* / Q000706:statistics & numerical data; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D005260:Female; D058005:General Practitioners; D017048:Health Care Costs; D006296:Health Services / Q000145:classification / Q000191:economics; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare / Q000191:economics*; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D012016:Reference Values; D013038:Specialization; D014481:United States
keywords: child; economics; health service research; infant; longitudinal study; special health care need