@article{Beaney:2021:10.1136/bmjopen-2021-050847,
author = {Beaney, T and Clarke, J and Woodcock, T and McCarthy, R and Saravanakumar, K and Barahona, M and Blair, M and Hargreaves, D},
doi = {10.1136/bmjopen-2021-050847},
journal = {BMJ Open},
pages = {1--14},
title = {Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London},
url = {http://dx.doi.org/10.1136/bmjopen-2021-050847},
volume = {11},
year = {2021}
}

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TY  - JOUR
AB  - ObjectivesWith a growing role for health services in managing population health, there is a need for early identification of populations with high need. Segmentation approaches partition the population based on demographics, long-term conditions (LTCs) or healthcare utilisation but have mostly been applied to adults. Our study uses segmentation methods to distinguish patterns of healthcare utilisation in children and young people (CYP) and to explore predictors of segment membership.DesignRetrospective cohort study.SettingRoutinely collected primary and secondary healthcare data in Northwest London from the Discover database.Participants378,309 CYP aged 0-15 years registered to a general practice in Northwest London with one full year of follow-up.Primary and secondary outcome measuresAssignment of each participant to a segment defined by seven healthcare variables representing primary and secondary care attendances, and description of utilisation patterns by segment. Predictors of segment membership described by age, sex, ethnicity, deprivation and LTCs.ResultsParticipants were grouped into six segments based on healthcare utilisation. Three segments predominantly used primary care; two moderate utilisation segments differed in use of emergency or elective care, and a high utilisation segment, representing 16,632 (4.4%) children accounted for the highest mean presentations across all service types. The two smallest segments, representing 13.3% of the population, accounted for 62.5% of total costs. Younger age, residence in areas of higher deprivation, and presence of one or more LTCs were associated with membership of higher utilisation segments, but 75.0% of those in the highest utilisation segment had no LTC.ConclusionsThis article identifies six segments of healthcare utilisation in CYP and predictors of segment membership. Demographics and LTCs may not explain utilisation patterns as strongly as in adults which may limit the use of routine data in predicting ut
AU  - Beaney,T
AU  - Clarke,J
AU  - Woodcock,T
AU  - McCarthy,R
AU  - Saravanakumar,K
AU  - Barahona,M
AU  - Blair,M
AU  - Hargreaves,D
DO  - 10.1136/bmjopen-2021-050847
EP  - 14
PY  - 2021///
SN  - 2044-6055
SP  - 1
TI  - Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2021-050847
UR  - https://bmjopen.bmj.com/content/11/12/e050847
UR  - http://hdl.handle.net/10044/1/93152
VL  - 11
ER  - 

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