Medical, Social, and Economic Factors Associated with Health-Related Quality of Life in Canadian Children with Hydrocephalus

Objective To study the factor: associated with health-related quality of life (HRQL,) in Canadian children with hydrocephclus, using a comprehensive model of determinants of child health, including socioeconomic factors. Study design A cross-sectional study was performed between November 2005 and November 2006 at 3 Canadian pediatric hospitals. Parents of children with hydrocephalus age 5 to 18 years completed the Hydrocephalus Outcome Questionnaire (HOQ) and the Health Utilities Index Mark 3 (HUI-3). Results A consecutive sample of 340 subjects participated from a total of 366 eligible children (mean age, 11.6 +/- 3.6 rears; mean time front the diagnosis of hydrocephalus, 10.0 +/- 4.6 years). Adjusted multivariate linear regression models demonstrated that the most important determinants of poorer HRQL included lower family income, lower parental education, worse family functioning, seizures, myelomeningocele, and prolonged treatment for cerebrospinal fluid shunt obstructions. Conclusions Despite a national universal health care system, socioeconomic disparities remain important as determinants of HRQL. Given the absence of a parallel private health care system in Canada, this suggests that the impact of socioeconomic actors is related to issues other than access to care. (J. Pediatr 2008;153:689-95)