Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study

Abstract

Purpose. This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative samples of children.

Method. Data were from three biennial waves (2004–2008) of the Longitudinal Study of Australian Children (B cohort: 0–5 years; K cohort: 4–9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0–3 years) and directly assessed vocabulary (4–9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme.

Result. It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0–1, 2–3, and 4–5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4–5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6–7 and 8–9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2–$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311; p = .002) for each additional wave of language difficulties.

Conclusion. Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.

Keywords::

• Language
• healthcare
• costs
• economic
• children
• longitudinal

Acknowledgements

This article uses confidential unit record files from the Longitudinal Study of Australian Children (LSAC) survey. The LSAC study was initiated and funded by the former Commonwealth Department of Families, Housing, Community Services, and Indigenous Affairs (now known as the Department of Social Services), and was managed by the Australian Institute of Family Studies. The findings and views reported in this article are those of the authors and should not be attributed to either the former Commonwealth Department of Families, Housing, Community Services, and Indigenous Affairs, or the Australian Institute of Family Studies. We thank all the families participating in the LSAC study. This work was supported by Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence funding (ES, EW, MW, FM, LG, JN, SR:1023493). Drs Sciberras, Mensah, and Gold were funded by NHMRC Population Health Capacity Building Grants (436914 and 425855) and NHMRC Early Career Research Fellowships (ES: 1037159; FM: 1037449; LG: 1035100). Professors Wake, Nicholson, and Reilly were supported by NHMRC Career Development Awards (MW: 546405; JN: 390136), Research (MW: 1046518) and Practitioner Fellowships (SR: 1041892). MCRI research is supported by the Victorian Government’s Operational Infrastructure Support Program, and the Parenting Research Centre receives funding from the Victorian Government Department of Education and Early Child Development. We acknowledge the peer review provided by the LSAC analysis group comprising staff from the Parenting Research Centre and Murdoch Childrens Research Institute.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.