Universal healthcare for hydrocephalus does not translate to universal quality-of-life outcomes

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This cross-sectional survey of 340 children with hydrocephalus attending neurosurgical follow-up clinics in Toronto, Vancouver, and Halifax quantified long-term health-related quality-of-life (HRQL) outcomes under a national universal healthcare program. Parents completed questionnaires assessing five domains of child health influences: biology, family structure, socioeconomic status, family/community environment, and healthcare. Despite the intent of universal access to care, socioeconomic factors were associated with disparities in HRQL. Kulkarni et al provide insightful discussion of the context and possible causal relationships of their findings.