Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in JapanReport as inadecuate

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BMC Health Services Research

, 16:602

Utilization, expenditure, economics and financing systems


BackgroundTreatment costs for children with growth hormone GH deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits boys: 156.4 cm; girls: 145.4 cm. However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation.

MethodsA retrospective analysis of 696 adolescent patients 451 boys and 245 girls who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects.

ResultsOf the 696 children in the analysis, 108 15.5 % were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not 75.9 % vs. 52.0 %, P < 0.001. The odds ratios of financial support to continuing treatment were 4.04 95 % confidence interval CI: 1.86–8.78 in boys and 1.72 95 % CI: 0.80–3.70 in girls, after adjusting for demographic characteristics and clinical factors.

ConclusionsFinancial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.

KeywordsPublic funding Health insurance Children with special health care needs Japan AbbreviationsGHGrowth hormone

GHDGrowth hormone deficiency

MAPChDMedical Aid Program for Chronic Pediatric Diseases of Specified Categories

OROdds ratio

SDSStandard deviation score

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Author: Eri Maeda - Takahiro Higashi - Tomonobu Hasegawa - Susumu Yokoya - Takahiro Mochizuki - Tomohiro Ishii - Junko Ito - Susumu

Source: https://link.springer.com/

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