Ann Rehabil Med.  2014 Dec;38(6):784-790. 10.5535/arm.2014.38.6.784.

Age Specificity in General and Rehabilitation Medical Services in Children With Cerebral Palsy

• Kim DA
• Hong HS
• Lee HY
• Lee HS
• Kang MS

• KMID: 2267088
• DOI: http://doi.org/10.5535/arm.2014.38.6.784

Abstract

OBJECTIVE
To review the medical utilization in children with cerebral palsy according to age and discern particularities
METHODS
From January 2007 to December 2007, 10,659 children and adolescents between 1 and 18 years of age who had filed national insurance claims for a diagnosis of cerebral palsy were selected. Age was chosen as an independent variable, and the population was categorized into specific age groups to verify any differences in medical service utilization. Admission duration to rehabilitation, number of visits to rehabilitation outpatient clinics, numbers of admission dates and outpatient clinic visits for general medical services, number of rehabilitation utilizations, and type of rehabilitations treatment were selected as dependent variables. One-way ANOVA was used for statistical evaluation, and analysis was done with SAS software.
RESULTS
In general medical use, adolescences diagnosed with cerebral palsy had the highest mean admission duration (p<0.001). The mean visit day to outpatient clinics for general medical services was highest for infants (p<0.001). In rehabilitation treatment, infants diagnosed with cerebral palsy had the highest mean admission duration (p<0.001). The mean visit day to outpatient clinics for rehabilitation treatment was highest for infants (p<0.001).
CONCLUSION
Significant differences in use of general and rehabilitation medical services among pediatric age groups with cerebral palsy were evident. This implies that particular attention is necessary when setting up a national medical care policy for patient with cerebral palsy.

Keyword

Cerebral palsy; Age; Cost; Visit; Treatment

MeSH Terms

Adolescent
Ambulatory Care Facilities
Cerebral Palsy*
Child*
Diagnosis
Humans
Infant
Insurance
Rehabilitation*
Sensitivity and Specificity*

Reference

1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007; 109:8–14. PMID: 17370477.

2. Yeargin-Allsopp M, Van Naarden Braun K, Doernberg NS, Benedict RE, Kirby RS, Durkin MS. Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Pediatrics. 2008; 121:547–554. PMID: 18310204.

3. Park MS, Kim SJ, Chung CY, Kwon DG, Choi IH, Lee KM. Prevalence and lifetime healthcare cost of cerebral palsy in South Korea. Health Policy. 2011; 100:234–238. PMID: 20952086.

4. Bhushan V, Paneth N, Kiely JL. Impact of improved survival of very low birth weight infants on recent secular trends in the prevalence of cerebral palsy. Pediatrics. 1993; 91:1094–1100. PMID: 8502508.

5. Dennis J, Matthews PW. Cerebral palsy. In : Molnar GE, Alexander MA, editors. Pediatric rehabilitation. 3rd ed. Philadelphia: Hanley & Belfus;1999. p. 193–217.

6. Cummins SK, Nelson KB, Grether JK, Velie EM. Cerebral palsy in four northern California counties, births 1983 through 1985. J Pediatr. 1993; 123:230–237. PMID: 8345418.

7. Hagberg B, Hagberg G, Olow I. The changing panorama of cerebral palsy in Sweden. VI. Prevalence and origin during the birth year period 1983-1986. Acta Paediatr. 1993; 82:387–393. PMID: 8318808.

8. Kim SJ, Lee EH, Lee SH, Park BK, Sung IY, Na JK. Survey of the demands of the parents of children with cerebral palsy. J Korean Acad Rehabil Med. 2000; 24:1070–1078.

9. Holt RL, Mikati MA. Care for child development: basic science rationale and effects of interventions. Pediatr Neurol. 2011; 44:239–253. PMID: 21397164.

10. Sung IY, Shin YB, Park SS. Clinical feature and treatment of cerebral palsy. In : Sung IY, editor. Pediatric rehabilitation. 2nd ed. Seoul: Koonja;2013. p. 383–416.

11. Park CI, Park ES, Shin JC, Kim SW, Choi EH. Early treatment effect in children with cerebral palsy and delayed development. J Korean Acad Rehabil Med. 1999; 23:1127–1133.

12. Hayashi M. The effect of early treatment for children with cerebral palsy in cooperation with city health welfare offices. No To Hattatsu. 1995; 27:480–486. PMID: 8534514.

13. Pain H. Coping with a child with disabilities from the parents' perspective: the function of information. Child Care Health Dev. 1999; 25:299–312. PMID: 10399034.

14. Palmer FB, Shapiro BK, Wachtel RC, Allen MC, Hiller JE, Harryman SE, et al. The effects of physical therapy on cerebral palsy: a controlled trial in infants with spastic diplegia. N Engl J Med. 1988; 318:803–808. PMID: 3280999.

15. Zonta MB, Bruck I, Puppi M, Muzzolon S, Neto Ade C, Coutinho dos Santos LH. Effects of early spasticity treatment on children with hemiplegic cerebral palsy: a preliminary study. Arq Neuropsiquiatr. 2013; 71:453–461. PMID: 23857615.

16. Kim DS, Choi JU, Yang KH, Park CI. Selective posterior rhizotomy in children with cerebral palsy: a 10-year experience. Childs Nerv Syst. 2001; 17:556–562. PMID: 11585331.

17. Andersson C, Mattsson E. Adults with cerebral palsy: a survey describing problems, needs, and resources, with special emphasis on locomotion. Dev Med Child Neurol. 2001; 43:76–82. PMID: 11221908.

18. Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up study. Dev Med Child Neurol. 2009; 51:381–388. PMID: 19207296.

19. Jahnsen R, Villien L, Aamodt G, Stanghelle JK, Holm I. Musculoskeletal pain in adults with cerebral palsy compared with the general population. J Rehabil Med. 2004; 36:78–84. PMID: 15180222.

20. Jahnsen R, Villien L, Stanghelle JK, Holm I. Fatigue in adults with cerebral palsy in Norway compared with the general population. Dev Med Child Neurol. 2003; 45:296–303. PMID: 12729142.

21. Murphy KP, Boutin SA, Ide KR. Cerebral palsy, neurogenic bladder, and outcomes of lifetime care. Dev Med Child Neurol. 2012; 54:945–950. PMID: 22788916.

22. Veugelers R, Benninga MA, Calis EA, Willemsen SP, Evenhuis H, Tibboel D, et al. Prevalence and clinical presentation of constipation in children with severe generalized cerebral palsy. Dev Med Child Neurol. 2010; 52:e216–e221. PMID: 20497454.

23. Sheridan KJ. Osteoporosis in adults with cerebral palsy. Dev Med Child Neurol. 2009; 51(Suppl 4):38–51. PMID: 19740209.

24. Simpson DM, Gracies JM, Graham HK, Miyasaki JM, Naumann M, Russman B, et al. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008; 70:1691–1698. PMID: 18458229.

25. McLaughlin J, Bjornson K, Temkin N, Steinbok P, Wright V, Reiner A, et al. Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials. Dev Med Child Neurol. 2002; 44:17–25. PMID: 11811645.

26. Woo R. Spasticity: orthopedic perspective. J Child Neurol. 2001; 16:47–53. PMID: 11225956.

27. Parkinson KN, Gibson L, Dickinson HO, Colver AF. Pain in children with cerebral palsy: a cross-sectional multicentre European study. Acta Paediatr. 2010; 99:446–451. PMID: 20003101.

28. Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH. Characteristics of recurrent musculoskeletal pain in children with cerebral palsy aged 8 to 18 years. Dev Med Child Neurol. 2011; 53:1013–1018. PMID: 22014321.

29. Henderson RC, Kairalla JA, Barrington JW, Abbas A, Stevenson RD. Longitudinal changes in bone density in children and adolescents with moderate to severe cerebral palsy. J Pediatr. 2005; 146:769–775. PMID: 15973316.

30. Kim SJ. Cerebral palsy. J Korean Acad Rehabil Med. 2000; 24:809–816.

31. Savage K, Kritas S, Schwarzer A, Davidson G, Omari T. Whey- vs casein-based enteral formula and gastrointestinal function in children with cerebral palsy. JPEN J Parenter Enteral Nutr. 2012; 36(1 Suppl):118S–123S. PMID: 22237871.