The association between multimorbidity in families and children's healthcare use: a cross-sectional study of households in the Lolland Falster Health Study (LOFUS).

backgroundChronic illness among adults is common, and an increasing number of children grow up in households where one or more adults live with long-term health conditions. While previous research has shown that parental physical or mental illness may influence children's mental health, less is known about how adult multimorbidity affects children's physical health and their healthcare use. This study aimed to investigate the association between household-level multimorbidity and healthcare use among school-aged children.

methodsThis cross-sectional study used data from the Danish Lolland-Falster Health Study (LOFUS), including 1,065 children aged 6-12 years living in 777 households. Children's questionnaire data were linked to adult data and national health registers. Adult chronic conditions were identified using questionnaire data and ICD-10 diagnoses, and household multimorbidity was defined as ≥ 2 chronic conditions among co-resident adults. Children's healthcare use, including general practice contacts, out-of-hours/emergency room visits, hospital admissions, and redeemed antibiotic prescriptions, was assessed over 12 months. Associations were analyzed using two-part regression models adjusted for children- and household-level covariates. Analyses were further stratified according to the presence of adult mental illness in the household.

resultsChildren living in households with multimorbidity had a significantly higher overall volume of contacts with general practice compared with children from households without multimorbidity. This association was primarily driven by households in which multimorbidity included adult mental illness. Among children who had experienced hospital admission, those from households with multimorbidity had more frequent admissions, although the overall likelihood of admission did not differ between groups. No statistically significant differences were observed for out-of-hours contacts, emergency room visits, or antibiotic prescriptions.

conclusionsHousehold multimorbidity was associated with increased healthcare use among children, particularly in relation to general practice. The findings suggest that children's healthcare use is influenced not only by their own health needs but also by the household's broader health context. A household-level perspective may therefore contribute to a more nuanced understanding of patterns of healthcare use among children and support clinical awareness in primary care.