Impact of child maltreatment on the costs of health service use and productivity loss: Findings from the Australian child maltreatment study.

BACKGROUND

Child maltreatment (CM) poses a substantial health burden, but its impact on healthcare costs and productivity loss in Australia remains unclear.

OBJECTIVE

To estimate the costs of health service use and productivity loss associated with CM in Australia.

PARTICIPANTS

Cross-sectional data (N = 8503) from the Australian Child Maltreatment Study were analyzed to identify people with CM, their health service use, and employment status.

METHODS

Hurdle models estimated in two parts, comprising logistic regression and generalized linear models, were used to estimate differences in health service use and average costs between those with and without CM. Unit costs of health services were sourced from national databases (e.g., Medicare Benefits Schedule). Productivity losses were estimated using the human capital approach. Sensitivity analyses were conducted to examine the robustness of findings.

RESULTS

Annual healthcare costs for each individual with CM was A$1670 higher than those without CM. Incremental productivity losses due to unemployment averaged A$2750 per labor force participant with CM annually. The point estimates of these costs increased with the number of CM subtypes experienced and remained highest among those with any neglect, sexual, and emotional abuse. A notable portion of health service use costs was attributed to mental health services. Subgroup analyses also revealed higher health service use costs for females and individuals with diverse gender identities. Findings mostly remained robust across sensitivity analyses. At a population level, CM was associated with annual health service use costs of A$21.6 billion and productivity losses of A$24.1 billion.

CONCLUSION

CM imposes substantial health service use and productivity costs in Australia. Targeted investment in prevention strategies is urgently needed.