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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

Neil, AL ORCID: 0000-0002-1344-6672, Chappell, K ORCID: 0000-0003-0842-6316, Wagg, F, Miller, A and Judd, F 2021 , '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' , Social Science and Medicine, vol. 284 , pp. 1-9 , doi: 10.1016/j.socscimed.2021.114216.

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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.

Item Type: Article
Authors/Creators:Neil, AL and Chappell, K and Wagg, F and Miller, A and Judd, F
Keywords: child health, emergency department, health service utilisation, linked data analysis, maternal health, rural and regional
Journal or Publication Title: Social Science and Medicine
Publisher: Pergamon Press
ISSN: 0277-9536
DOI / ID Number: 10.1016/j.socscimed.2021.114216
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© 2021 Elsevier Ltd. All rights reserved.

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