title: Medical service use in children with cerebral palsy: The role of child and family factors characteristics.
abstract: OBJECTIVE
  The aim of the study was to investigate the patterns of medical service use in children with cerebral palsy (CP), taking into account child and family characteristics.
  
  
  METHODS
  Nine hundred and one parents and carers of children registered with the Victorian CP Register were invited to complete a survey. Participants were asked about their child's appointments with general practitioners and public and private paediatric medical specialists over the preceding 12 months. Information on family characteristics and finances was also collected. Data on CP severity and complexity were extracted from the CP Register.
  
  
  RESULTS
  Three hundred and fifty parents and carers (39%) participated. Of these, 83% reported that their child had ≥1 appointment with a general practitioner over the preceding 12 months, while 84% had ≥1 appointment with a public or private paediatric medical specialist. Overall, 58% of children saw 2-5 different paediatric medical specialists, while 9% had appointments with ≥6 clinicians. Children with severe and complex CP were more likely to have had ≥1 appointment with a publically funded paediatric medical specialist and had seen a greater number of different clinicians over the study period. Family characteristics were not associated with service use.
  
  
  CONCLUSIONS
  Children with CP are managed by a number of paediatric medical specialists, and they continue to see a range of specialists throughout adolescence. In Victoria, differences in service use are not based on family characteristics; instead the highest service users are those with severe and complex CP. For this group, care co-ordination and information sharing between treating clinicians are important, if gaps in care are to be avoided.
authors.affiliation: Department of Paediatrics.|Developmental Disability and Rehabilitation Research, Clinical Sciences.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Meehan
authors.affiliation: Department of Paediatrics.|Developmental Disability and Rehabilitation Research, Clinical Sciences.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Reid
authors.affiliation: Department of Paediatrics.|Developmental Disability and Rehabilitation Research, Clinical Sciences.|Developmental Medicine.|Deakin Child Study Centre, School of Psychology, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Williams
authors.affiliation: Health Systems and Workforce Unit, Centre for Health Policy, School of Population and Global Health, University of Melbourne.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Freed
authors.affiliation: Department of Paediatrics.|Community Health Services Research, Population Health, Murdoch Childrens Research Institute.|Centre for Community Child Health, Royal Children's Hospital, Australia.
authors.forename: Jillian R
authors.initials: JR
authors.lastname: Sewell
authors.affiliation: Department of Paediatrics.|Developmental Disability and Rehabilitation Research, Clinical Sciences.|Developmental Medicine.
authors.forename: Dinah S
authors.initials: DS
authors.lastname: Reddihough
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012042:Registries; D055815:Young Adult
keywords: cerebral palsy; health expenditure; health service; service use