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Chronic illness and functional limitation in Ontario children: findings of the Ontario Child Health Study.

https://arctichealth.org/en/permalink/ahliterature236486
Source
CMAJ. 1986 Oct 1;135(7):761-7
Publication Type
Article
Date
Oct-1-1986
Author
D. Cadman
M H Boyle
D R Offord
P. Szatmari
N I Rae-Grant
J. Crawford
J. Byles
Source
CMAJ. 1986 Oct 1;135(7):761-7
Date
Oct-1-1986
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Child
Child Health Services - utilization
Child, Preschool
Chronic Disease - epidemiology
Female
Health Surveys
Humans
Male
Ontario
Sampling Studies
Socioeconomic Factors
Abstract
The Ontario Child Health Study (OCHS) was based on interviews of 1869 Ontario families who were selected by means of a stratified, multistaged sampling method from the 1981 census of Canada. Its primary purpose was to determine the prevalence and distribution of mental health problems in Ontario children aged 4 to 16 years and their families, but it also allowed an estimate of other significant medical conditions and provided an overview of these children's use of health care, education and social services. Our results are based on questionnaire responses concerning 3294 children. Limitation of function without a chronic illness or medical condition was reported in 1.9%, the converse in 14.0%, and a chronic illness or medical condition with limitation of function in 3.7%. When the three groups are considered together, 19.6% of Ontario children had a chronic health problem. Children of lower socioeconomic status were much more likely to have chronic health problems. Overall, children with chronic health problems were more likely to use physician, special education, social and mental health services. These findings have implications for those who provide services for children, plan community programs or train professionals in caring for children.
Notes
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Cites: Child Care Health Dev. 1978 Jan-Feb;4(1):9-19630660
Cites: N Engl J Med. 1984 Aug 23;311(8):506-116749208
Cites: Pediatrics. 1982 May;69(5):550-76281719
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Cites: Med Care. 1979 Sep;17(9):902-21480998
PubMed ID
3756702 View in PubMed
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Chronic illness, disability, and mental and social well-being: findings of the Ontario Child Health Study.

https://arctichealth.org/en/permalink/ahliterature235306
Source
Pediatrics. 1987 May;79(5):805-13
Publication Type
Article
Date
May-1987
Author
D. Cadman
M. Boyle
P. Szatmari
D R Offord
Source
Pediatrics. 1987 May;79(5):805-13
Date
May-1987
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Child
Child Health Services - utilization
Child Psychology
Child, Preschool
Chronic Disease - psychology
Disabled Persons - psychology
Female
Health Surveys
Humans
Male
Mental Disorders - epidemiology
Ontario
Social Adjustment
Abstract
Chronic childhood illness, disability, and psychosocial problems are receiving major attention in current pediatric care. Much of the evidence associating chronic physical problems and mental health and adjustment problems has come from clinic-based studies and is often inconsistent in its conclusions. This paper reports the findings of the Ontario Child Health Study, an epidemiologic survey of 3,294 children 4 to 16 years of age in the general community, concerning the relationship of psychiatric disorders and social adjustment problems among children with chronic illness, medical conditions, and long-term disability in contrast to children free of chronic physical health problems. Age- and sex-adjusted risks for psychiatric disorders and social problems, compared with those for healthy peers, were calculated: children with both chronic illness and associated disability were at greater than threefold risk for psychiatric disorders and considerable risk for social adjustment problems. Children with chronic medical conditions, but no disability, were at considerably less risk: about a twofold increase in psychiatric disorders but little increased risk for social adjustment problems was observed. A relative underuse of specialized mental health services by children who might benefit supports the opinion that all physicians in the community who care for children with chronic health problems should become skilled in the recognition of existing or incipient mental health and social problems and familiar with preventive and treatment approaches that may lessen the excessive burden of psychosocial problems among those with chronic ill-health.
PubMed ID
2952939 View in PubMed
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Ontario Child Health Study: patterns of ambulatory medical care utilization and their correlates.

https://arctichealth.org/en/permalink/ahliterature232501
Source
Pediatrics. 1988 Sep;82(3 Pt 2):425-34
Publication Type
Article
Date
Sep-1988
Author
C A Woodward
M H Boyle
D R Offord
D T Cadman
P S Links
H. Munroe-Blum
C. Byrne
H. Thomas
Author Affiliation
Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
Source
Pediatrics. 1988 Sep;82(3 Pt 2):425-34
Date
Sep-1988
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Ambulatory Care - utilization
Child
Child Health Services - utilization
Child, Preschool
Chronic Disease
Educational Status
Female
Health status
Humans
Insurance, Health, Reimbursement
Male
Mental health
Ontario
Patient Acceptance of Health Care
Urban health
Abstract
Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.
PubMed ID
3405678 View in PubMed
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Correlates of children's use of physician and dentist services: Ontario Child Health Study follow-up.

https://arctichealth.org/en/permalink/ahliterature221615
Source
Can J Public Health. 1993 Mar-Apr;84(2):103-6
Publication Type
Article
Author
C A Woodward
M H Boyle
D R Offord
Y A Racine
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON.
Source
Can J Public Health. 1993 Mar-Apr;84(2):103-6
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Attitude to Health
Child
Child Health Services - utilization
Dental Health Services - utilization
Female
Follow-Up Studies
Health services needs and demand
Health Services Research
Humans
Logistic Models
Male
Ontario
Parents - psychology
Patient Acceptance of Health Care
Urban Population
Abstract
(1) To explore the correlates of dental and medical care utilization for children in Ontario and (2) to explore the stability of correlates of medical care use over time.
Data from the Follow-up Survey of the Ontario Child Health Study were used. Since likelihood of use of both dental and medical care clustered within households, one randomly chosen child per household, aged 8-16 years, contributed data to the analysis. Bivariate associations between use of services and descriptors of the child and his/her family were examined.
Younger age, urban residents and parental perception of poorer health or hay fever/asthma increased the odds of a child receiving medical care in the previous six months. Dental care utilization was associated with younger age of child, higher education of mother and high family income.
Across time, consistency was observed in the factors linked to children's use of medical services. Perceived need, the child's age and an urban location are related to greater probability of use.
PubMed ID
8334600 View in PubMed
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Ontario Child Health Study. Summary of selected results.

https://arctichealth.org/en/permalink/ahliterature230367
Source
Can J Psychiatry. 1989 Aug;34(6):483-91
Publication Type
Article
Date
Aug-1989
Author
D R Offord
M H Boyle
J E Fleming
H M Blum
N I Grant
Author Affiliation
Department of Psychiatry, McMaster University, Ontario.
Source
Can J Psychiatry. 1989 Aug;34(6):483-91
Date
Aug-1989
Language
English
Publication Type
Article
Keywords
Adolescent
Affective Symptoms - epidemiology
Attention Deficit Disorder with Hyperactivity - epidemiology
Child
Child Behavior Disorders - epidemiology
Child Health Services - utilization
Child, Preschool
Cross-Sectional Studies
Female
Humans
Male
Mental Disorders - epidemiology
Ontario
Referral and Consultation - utilization
Risk factors
Somatoform Disorders - epidemiology
Abstract
Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.
PubMed ID
2788490 View in PubMed
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