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Psychosocial morbidity: the economic burden in a pediatric health maintenance organization sample
P Bernal1, D B Estroff, J F Aboudarham
1Department of Psychiatry, Kaiser Permanente Medical Group, San Jose, Calif 95119, USA.
Insights
Children with psychosocial morbidity utilize more health care, especially younger children. This increased utilization also correlates with higher psychiatric care costs as children age.
Area of Science:
- Pediatric Health Services Research
- Child and Adolescent Psychiatry
- Health Economics
Background:
- Psychosocial morbidity is a significant concern in pediatric primary care.
- Understanding its impact on healthcare utilization is crucial for resource allocation.
Purpose of the Study:
- To evaluate psychosocial morbidity in pediatric primary care.
- To determine the relationship between psychosocial dysfunction and healthcare utilization and costs.
Main Methods:
- Cross-sectional study of 1840 parent-child dyads screened using the Pediatric Symptom Checklist (PSC).
- Analysis of health and psychiatric care costs and utilization data from a health maintenance organization (HMO).
Main Results:
- 13.0% of children showed psychosocial dysfunction; 18.4% had chronic illnesses.
- Children with anxious/depressed symptoms incurred higher healthcare costs ($805 vs. $393 average).
- Psychosocial morbidity, younger age, and chronic illness were associated with increased healthcare spending.
Conclusions:
- Children with psychosocial morbidity exhibit higher healthcare utilization.
- Younger children with psychosocial issues had the highest healthcare spending.
- Healthcare costs increased with age for psychiatric care, while overall utilization decreased.
Objectives:
To evaluate psychosocial morbidity in pediatric primary care and to determine displaced health care utilization.
Design And Setting:
A cross-sectional sample of parent-child dyads was screened using the Pediatric Symptom Checklist (PSC) at 6 pediatric sites of a health maintenance organization (HMO). Cost and utilization data were retrieved from regional databases for this sample.
Participants:
Parent-child dyads from an HMO in northern California (N = 1840). The children ranged in age from 2 to 18 years.
Results:
In all, 13.0% of children exhibited psychosocial dysfunction. The rate of children's chronic illness was 18.4%. Multiple regression analyses measured utilization and cost of health and psychiatric care for the selected population for the previous year; the average log cost of health care per child was $393. The average health care cost for children with anxious, depressed symptoms was $805. Chronically ill children were the highest utilizers of health care, with an average log cost of $1138. When psychosocial dysfunction was present, regression models showed that health care spending was highest for young children.
Conclusions:
Health care utilization was higher for children with psychosocial morbidity, was higher among younger children, and decreased with age as psychiatric costs progressively increased.
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