Healthcare use and costs associated with children's behavior problems

Area of Science:

• Pediatric healthcare utilization
• Child psychology and behavior disorders
• Health economics

Background:

• Behavioral problems in school-aged children are a significant concern impacting healthcare resource allocation.
• Understanding the relationship between behavior problem severity and healthcare costs is crucial for public health planning.

Purpose of the Study:

• To investigate the association between the severity of behavior problems and specific symptom domains with healthcare use and costs in school-aged children.
• To analyze direct medical costs and utilization patterns based on behavior problem severity.

Main Methods:

• Cross-sectional study utilizing data from two population-based birth cohorts in Germany (N=3,579).
• Parent-reported Strengths and Difficulties Questionnaire (SDQ) assessed behavior problem severity and domains.
• Healthcare use and direct medical costs were calculated from parent-reported utilization over 12 months.

Main Results:

• Total direct medical costs demonstrated a graded relationship with behavior problem severity (p < 0.0001).
• Children with abnormal difficulties incurred significantly higher annual costs (Euro 1,237) compared to those with normal difficulties.
• Emotional symptoms were associated with the highest costs for physicians, psychotherapists, and hospitalization; hyperactivity/inattention linked to therapist and emergency room costs.

Conclusions:

• Healthcare use and costs in children are significantly related to the severity of their behavior problems.
• Lower-than-expected psychotherapy costs suggest potential underdiagnosis or undertreatment, indicating possible gaps in accessing appropriate care.
• High hospitalization costs in children with emotional symptoms may be partly attributable to underlying medical conditions.