Abstract
Background: Children with complex chronic conditions have a high need for health and social care resources. Many parents explore parallel resources such as alternative therapies, associations, psychological support, private medical consultations, and other out-of-pocket expenses for healthcare. The use of these alternative health resources is sometimes unclear and may lead to health inequalities. To characterize the use made of alternative healthcare resources for children with complex chronic conditions. Additionally, we evaluate the influence of sociodemographic factors on the distribution of this utilization of resources; (2) Methods: Cross-sectional study. Children with complex chronic diseases were treated at a tertiary hospital in Granada, Spain in 2016. We analyzed their use of healthcare resources and socioeconomic variables. This research complies with STROBE guidelines for observational studies; (3) Results: In total, 265 children were analyzed (mean age 7.3 years, SD 4.63). A total of 105 children (39.6%) attended private consultations with specialists, and 12.1% (n = 32) of the children had additional private health insurance. One out three parents belonged to a mutual support association (n = 78), and 26% (n = 69) of the children used alternative therapies. Furthermore, 75.4% (n = 199) of the children received no psychological support. Children whose parents had a higher educational level and occupations status made greater use of parallel healthcare resources.; (4) Conclusions: A significant proportion of children used multiple health resources in addition to the public healthcare system depending on sociodemographic determinants. Studies are needed to determine whether the use of these alternative services achieves better levels of health.
Highlights
The main aim of this study is to characterize the use of health resources additional to the services offered by the public health system, for children with complex chronic diseases, to identify patterns of use according to sociodemographic factors and life-threatening complex chronic conditions (LT-CCCs) criteria
Our results show there is a relationship between the use of health insurance and private consultations, and having a higher occupational and educational level, as previously detected by the Spanish National Health Survey for the general population [19], and literature review [23]
Our study shows that most use of alternative therapies is made by those parents with a higher occupational and educational level
Summary
Many children’s lives are threatened or limited by an increased prevalence of chronic diseases, which are characterized by major health-related needs, severe chronic conditions, functional limitations, and the frequent need for healthcare resources [1] These circumstances have a substantial impact on the children and their families and pose a major challenge to health services, which have traditionally been oriented toward acute care. Families often report that their greatest challenge is that of overcoming fragmented communication across systems, services, and providers [5], along with care continuity gaps and frustrations with access to health services [6], all of which generate unmet service needs, in association with family factors and the disease itself [7] This issue is especially distressing in the case of children exposed to high levels of social vulnerability [8,9].
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