The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle

Amanda L Neil; Kate Chappell; Fiona Wagg; April Miller; Fiona Judd

doi:10.1016/j.socscimed.2021.114216

The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle

Soc Sci Med. 2021 Sep:284:114216. doi: 10.1016/j.socscimed.2021.114216. Epub 2021 Jul 10.

Authors

Amanda L Neil¹, Kate Chappell², Fiona Wagg³, April Miller², Fiona Judd⁴

Affiliations

¹ Menzies Institute for Medical Research, University of Tasmania, Australia. Electronic address: Amanda.Neil@utas.edu.au.
² Menzies Institute for Medical Research, University of Tasmania, Australia.
³ Child and Adolescent Mental Health Services South, Tasmanian Health Service, Hobart, Australia.
⁴ Menzies Institute for Medical Research, University of Tasmania, Australia; Perinatal and Infant Mental Health Team, CAMHS South, Tasmanian Health Service, Hobart, Australia.

PMID: 34274707
DOI: 10.1016/j.socscimed.2021.114216

Abstract

Background: Tasmania, Australia has a small widely dispersed regional and rural population. The Conception to Community (C2C) Study Database was established as a research platform to inform service planning and policy development and improve health outcomes for Tasmanian mothers and children. The aims of this study were to establish by maternal socio-demographic characteristics: 1) the distribution of births in Tasmania; 2) hospital utilisation for children from birth to 5-years; and 3) the association between child and maternal emergency department (ED) presentation rates.

Methods: Perinatal and public hospital ED and admitted patient data were linked for every child born in Tasmania between 2008-09 to 2013-14, and their mothers. Individualised rates of ED presentations and hospital admissions were calculated from birth to 5-years. Frequent presenters to ED were defined as having at least four presentations per annum. Ratios of ED presentation and hospital admission rates by sociodemographic characteristics (region (north, north-west, south), rurality, maternal age, and area socioeconomic disadvantage) were estimated using mixed-effects negative binomial models, with random intercepts for each child and family.

Results: The C2C Database is comprised of records for 37,041 children and 27,532 mothers. One-in-ten Tasmanian babies lived in a remote area. The mean yearly rate of ED presentations per child varied by sex, age, region and rurality. Frequent presenters were more likely to reside in the north-west or north, in urban areas, have mothers under 20- years, be male, and live in more disadvantaged areas, with 2.3% of children frequent presenters in their first year of life. The odds of a child being a frequent presenter during their first-year was 6.1- times higher if the mother was a frequent presenter during this period.

Conclusion: Associations between maternal and child health service use and combined effects of regionality and rurality highlight opportunities for targeted intervention and service innovations.

Keywords: Child health; Emergency department; Health service utilisation; Linked data analysis; Maternal health; Rural and regional.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Child
Emergency Service, Hospital*
Female
Hospitalization
Humans
Infant
Male
Models, Statistical
Pregnancy
Rural Population*