Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data
Background Health disparities for children with
intellectual disabilities can be challenging to measure
due to many other factors that can impact health and
healthcare use. The aim of the current study was to
use longitudinal cohort data to compare children with
intellectual disability (ID) in Ireland between 2006
and 2014 on healthcare utilisation and unmet need, at
ages 9 and 13, using a propensity score matching
(PSM) approach.
Methods Using data from the Growing up in Ireland
study, PSM was used to identify an appropriate control sample to compare with a sample of children with
ID (n = 124). Participants were matched on variables
that are known to influence healthcare utilisation to
reduce the impact of confounding variables between
groups so that differences between the groups can be
estimated. Logistic regression was used to estimate
effects at ages 9 and 13.
Results Children with ID were no more likely to have
visited a general practitioner or emergency
department in the past 12 months than children
without ID. They did have a greater likelihood of
visiting a doctor in a hospital in the past 12 months
and of having an overnight stay in hospital by age 9.
Primary caregivers of children with ID were more
likely to report unmet health needs at ages 9 and 13.
Conclusions This approach is a novel means of
comparing healthcare use in this population by
balancing the impact of other factors that may result
in inequities, to which children with ID may be more
vulnerable.