Elsevier

The Journal of Pediatrics

Volume 158, Issue 2, February 2011, Pages 194-200.e1
The Journal of Pediatrics

Original Article
Variation Over Time in Medical Conditions and Health Service Utilization of Children with Down Syndrome

https://doi.org/10.1016/j.jpeds.2010.08.045Get rights and content

Objectives

To compare the prevalence of parent reported medical conditions and rates of health service utilization in school-aged children with Down syndrome in Western Australia in 1997 and 2004.

Study design

We compared two cross-sectional surveys completed by parents of children with Down syndrome identified from population-based sources in 1997 (n = 210) and 2004 (n = 208). Surveys collected information on family demographics, medical conditions, health issues, and service utilization. The analysis described medical conditions in 2004 and compared frequencies in both years. Regression analyses compared medical conditions and health utilisation in the two cohorts.

Results

In 2004, children with Down syndrome had greater odds of having a bowel condition (OR, 1.69; 95%, 1.16 to 2.45; P = .01), were less likely to have a current problem due to their cardiac condition (OR, 0.32; 95% CI, 0.15 to 0.68, P = .003), and demonstrated an overall reduction in episodic illnesses and infections. The use of GP services (incidence rate ratio [IRR] = 0.91; 95% CI, 0.83 to 1.00, P = .05) and combined medical specialist visits (IRR = 0.92; 95% CI, 0.84 to 1.01; P = .09) were reduced in 2004, as were overnight hospital admissions (IRR = 0.60; 95% CI, 0.37 to 0.96; P = .03) and length of stay (IRR = 0.33; 95% CI, 0.24 to 0.44; P < .001).

Conclusions

The health status of children with Down syndrome has varied over time with reductions in current cardiac problems, episodic illnesses, and health service use. Research is now needed to investigate the impact of these changes on the overall health and quality of life of children and families living with Down syndrome.

Section snippets

Methods

Using the same population data source (formerly Disability Services Commission and now the Intellectual Disability Exploring Answers [IDEA] database16) as the sampling frame, questionnaires have been administered to Western Australian families of children with Down syndrome in 1997 and 2004 (Figure).17, 18 In 1997, the study was restricted to school-aged children and included birth years 1980 to 1991 but in 2004 was extended to include birth years 1980 to 2004. Response fractions for the two

Results

The characteristics of the 1997 cohort have previously been described in detail.17 The mean age of the 2004 study subjects was 11.7 years (range, 5.02 to 17.98); there were 90 females and 118 males.

Discussion

We aimed to compare the prevalences of medical conditions and rates of episodic illness in children with Down syndrome in 1997 and 2004 to identify any variation in health status over time. In addition, the study investigated whether there were any changes in health care utilization that might have related to improved health status or changes in availability of services. We found a significant reduction in ongoing cardiac conditions, and bowel and thyroid conditions were reported to be

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    Supported by the National Institutes of Health (grant 5R01HD043100-05). The authors declare no conflicts of interest.

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