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Care use and its intensity in children with complex problems are related to varying child and family factors: A follow-up study

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  • Noortje M Pannebakker
  • Paul L Kocken
  • Paula van Dommelen
  • Krista van Mourik
  • Ria Reis
  • Sijmen A Reijneveld
  • Mattijs E Numans

Abstract

Background: There is little evidence on the child and family factors that affect the intensity of care use by children with complex problems. We therefore wished to identify changes in these factors associated with changes in care service use and its intensity, for care use in general and psychosocial care in particular. Methods: Parents of 272 children with problems in several life domains completed questionnaires at baseline (response 69.1%) and after 12 months. Negative binominal Hurdle analyses enabled us to distinguish between using care services (yes/ no) and its intensity, i.e. number of contacts when using care. Results: Change in care use was more likely if the burden of adverse life events (ALE) decreased (odds ratio, OR = 0.94, 95% confidence interval, CI = 0.90–0.99) and if parenting concerns increased (OR = 1.29, CI = 1.11–1.51). Psychosocial care use became more likely for school-age children (vs. pre-school) (OR = 1.99, CI = 1.09–3.63) if ALE decreased (OR = 0.93, CI = 0.89–0.97) and if parenting concerns increased (OR = 1.26, CI = 1.10–1.45). Intensity of use (>0 contacts) of any care decreased when ALE decreased (relative risk, RR = 0.95, CI = 0.92–0.98) and when psychosocial problems became less severe (RR = 0.38, CI = 0.20–0.73). Intensity of psychosocial care also decreased when severe psychosocial problems became less severe (RR = 0.39, CI = 0.18–0.84). Conclusions: Changes in care-service use (vs. no use) and its intensity (>0 contacts) are explained by background characteristics and changes in a child’s problems. Care use is related to factors other than changes in its intensity, indicating that care use and its intensity have different drivers. ALE in particular contribute to intensity of any care use.

Suggested Citation

  • Noortje M Pannebakker & Paul L Kocken & Paula van Dommelen & Krista van Mourik & Ria Reis & Sijmen A Reijneveld & Mattijs E Numans, 2020. "Care use and its intensity in children with complex problems are related to varying child and family factors: A follow-up study," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-15, May.
    • Handle: RePEc:plo:pone00:0231620
    DOI: 10.1371/journal.pone.0231620
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    References listed on IDEAS

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    1. Pannebakker, Noortje M. & Kocken, Paul L. & Theunissen, Meinou H.C. & van Mourik, Krista & Crone, Matty R. & Numans, Mattijs E. & Reijneveld, Sijmen A., 2018. "Services use by children and parents in multiproblem families," Children and Youth Services Review, Elsevier, vol. 84(C), pages 222-228.
    2. Carme Saurina & Laura Vall-llosera & Marc Saez, 2012. "Factors determining access to and use of primary health care services in the Girona Health Region (Spain)," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 419-427, August.
    3. Tausendfreund, Tim & Knot-Dickscheit, Jana & Post, Wendy J. & Knorth, Erik J. & Grietens, Hans, 2014. "Outcomes of a coaching program for families with multiple problems in the Netherlands: A prospective study," Children and Youth Services Review, Elsevier, vol. 46(C), pages 203-212.
    4. Fernandez, Elizabeth, 2007. "Supporting children and responding to their families: Capturing the evidence on family support," Children and Youth Services Review, Elsevier, vol. 29(10), pages 1368-1394, October.
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