# Examining the hospital costs of children born into relative deprivation in England

## TL;DR

Children born in deprived areas in England have higher hospital costs during childhood compared to those from less deprived areas.

## Contribution

This study provides new evidence on the long-term healthcare cost disparities linked to early-life socioeconomic conditions.

## Key findings

- Children from the most deprived areas had higher hospital costs for inpatient, outpatient, and emergency care up to age 15.
- The highest cost differences occurred in the year following birth.
- While overall costs increased over time, the gap between the most and least deprived areas narrowed slightly by 2013/2014.

## Abstract

To examine the association between being born into relative deprivation and hospital costs during childhood.

Retrospective cohort study.

We created a birth cohort using Hospital Episode Statistics for children born in NHS hospitals in 2003/2004. The Index of Multiple Deprivation (IMD) rank at birth was missing from 75% of the baby records, so we linked mother and baby records to obtain the IMD decile from the mother’s record. We aggregated and costed each child’s hospital inpatient admissions, and outpatient and emergency department (ED) attendances up to 15 years of age. We used 2019/2020 NHS tariffs to assign costs. We constructed an additional cohort, all children born in 2013/2014, to explore any changes over time, comparing the utilisation and costs up to 5 years of age.

Our main cohort comprised 567 347 babies born in 2003/2004, of which we could include 91%. Up to the age of 15 years, children born into the most deprived areas used more hospital services than those born in the least deprived, reflected in higher costs of inpatient, outpatient and ED care. The highest costs and greatest differences are in the year following birth. Comparing this with the later cohort (up to age 5 years), the average cost per child increased across all deprivation deciles, but differences between the most and least deprived deciles appeared to narrow slightly.

Healthcare utilisation and costs are consistently higher for children who are born into the most deprived areas compared with the least.