Objective Knowledge about childhood functional somatic symptoms (FSS) and healthcare costs is scarce. This study aims to assess whether FSS in children aged 5–7 years are associated with increased future primary healthcare.
Design At baseline of the observational cohort study, between years 2005 and 2007, 1327 children from the Copenhagen Child Cohort were assessed at ages 5–7 years for FSS and chronic physical diseases using the Soma Assessment Interview. Information on primary healthcare use was obtained from the National Health Insurance Service Register, and measured as the price of all medical services outside the hospital during a 4.5-year follow-up period from the day of assessment. Regression with bootstrap bias-corrected and accelerated CIs were performed.
Results 1018 (76.8%) children had no FSS with primary healthcare use adjusted for other child health problems, maternal education and family changes of €448.2, 388.2–523.8 and number of face-to-face contacts: 11.90, 10.71–13.25; 250 (18.9%) had FSS with healthcare use €441.0, 355.0–550.3 and face-to-face contacts: 11.22, 9.60–12.91, and 58 (4.4%) had impairing FSS with healthcare use: €625.9, 447.9–867.8 and face-to-face contacts: 14.65, 11.20–19.00. In unadjusted regression analysis, impairing FSS were associated with increased healthcare use (increased costs: €246.0, 67.6–494.3). The adjusted association was slightly attenuated (increased costs: €177.8, 1.3–417.0).
Conclusions Impairing FSS in children aged 5–7 years is a predictor for the child's future primary healthcare use. More research on complex predictive models is needed to further explore the clinical significance of these results, and to contribute to the underpinning of early interventions towards impairing FSS in children.
- General Paediatrics
- Health services research
- Somatoform disorders
- Medically unexplained symptoms
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Contributors TGK took part in designing the study, carried out data preparation, took part in the analysis and interpretation of data, drafted the initial manuscript and prepared the final manuscript as submitted. AMS was initiator of the CCC2000, took part in gathering the data, took part in designing the study and critically revised the manuscript. JSJ took part in the statistical design of the study, supervised data preparation, took part in the statistical analysis and interpretation of data and critically revised the manuscript. CUR took part in gathering the data, took part in designing the study, supervised data preparation, analysis and interpretation and critically revised the manuscript.
Funding Steenbeck's Grant, Ulla and Mogens Folmer Andersen's Fund (798815 JGL/bkh), Mrs C Hermansen's Memorial Fund, Ville Heise's Grant (M01-13), The Beatrice Surovell Haskell Fund for Child Mental Health Research of Copenhagen (11531), Rosalie Petersen's Fund (020432-0001 hvh/hvh/sra), Fund of 1870 (200652).
Competing interests TG-K reports grants from Fund of 1870, grants from Mrs C. Hermansen's Memorial Fund, grants from Steenbeck's Grant, grants from The Beatrice Surovell Haskell Fund for Child Mental Health Research of Copenhagen, grants from Ulla and Mogens Folmer Andersen's Fund, grants from Ville Heise's Grant, during the conduct of the study.
Ethics approval Scientific Ethics Committee of Copenhagen County (KA-05103) and the Danish Data Protection Agency (2012-58-0004, RHP-2013-001).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Additional data on frequency of use within subspecialties can be obtained from the corresponding author on request.