Costs for physical and mental health hospitalizations in the first 13 years of life among children engaged with Child Protection Services
Objective: To estimate the costs of hospitalization for physical and mental health conditions by child protection status, including out-of-home-care (OOHC) placement, from birth until 13-years, and to assess the excess costs associated with child protection contact over this period.
Participants and Setting: Australian population cohort of 79,285 children in a multi-agency linkage study.
Methods: Costs of hospitalization were estimated from birth (if available) using Round 17, National Hospital Cost Data Collection (2012-13; deflated to 2015-16 AUD). Records of the state child protection authority determined contact status. Data were reported separately for children in OOHC. Hospital separations were classified as mental disorder-related if the primary diagnosis was recorded in ICD-10 Chapter V (F00-F99).
Results: Hospital separations were more common in children with child protection contact. Physical health care costs per child decreased with age for all children, but were significantly higher for children with contact. Mental health costs per child were always significantly higher for children with contact, with marked increases at 3 ≤ 4 years and 8 ≤ 9 years. Point estimates of annual costs per child were always highest for children with an OOHC placement. The net present value of the excess costs was $3,224 per child until 13- years, discounted at 5 %.
Conclusions: Children in contact with child protection services show higher rates and costs for physical and mental health hospitalizations in each of their first 13 years of life.
National Health & Medical Research Council
NSW Department of Family and Community Services
Publication titleChild Abuse & Neglect
Department/SchoolMenzies Institute for Medical Research
PublisherPergamon-Elsevier Science Ltd
Place of publicationThe Boulevard, Langford Lane, Kidlington, Oxford, England, Ox5 1Gb
Rights statementCopyright 2019 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/