Investigating Child Health Utility Differences and Socioeconomic Influences Among Children With Disabilities: A Longitudinal Study

OBJECTIVES: The "Child Health Utility 9D" (CHU9D) serves as a generic health-related quality of life (HRQoL) measure designed specifically for children and adolescents, aiming to assess their well-being and preferences for health states in nine dimensions. This study investigates the CHU9D score differences among various disability groups in comparison to normal children, with a focus on evaluating associated socio-economic risk factors influencing these scores.

METHODS: Utilizing data from the Longitudinal Study of Australian Children (LSAC), encompassing 16,514 observations from pooled dataset of children aged 10-17 years over three waves, this study applied CHU9D, a self-reported questionnaire encompassing dimensions: worry, sadness, pain, fatigue, annoyance, schoolwork, sleep, daily routine, and activities, to assess children's subjective experiences on child health utility. The combination across the nine dimensions forms a health state, which was transformed to a score for each child ranging from 0 (the worst health) to 1 (full health). In the analytical phase, a categorical variable was created, denoting children with normal health or sensory, physical, psychological, long-term medical or multiple disabilities. Socio-economic factors were considered to investigate the associated risk factors. Statistical modelling, both repeated-measure ANOVA regression and mixed-effect modelling, was employed for comprehensive insights.

RESULTS: Mixed effect modelling results indicate that children with physical (b=-0.04, p=0.048), psychological (b=-0.06, p=0.001), and multiple medical conditions (b=-0.07, p<0.001) exhibit significantly lower CHU9D scores compared to their normal counterparts. Additionally, factors such as residing in inner (b=0.01) and outer regional (b=0.02) Australia, female children (b=-0.07), having both parents at home (b=0.03), and the presence of any medical condition in primary carer (b=-0.02) significantly influence CHU9D utility score.

CONCLUSIONS: Understanding these status specific to children with disabilities is crucial for policymakers and healthcare providers. This study’s knowledge can help policymakers for supporting systems and services to enhance the overall quality of life for these children.