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Associations Between Mental and Physical Illness Comorbidity and Hospital Utilization
Jennifer E Holland1, David C Rettew1,2,3,4, Susan E Varni1,2
1The Robert Larner, M.D. College of Medicine.
Hospital Pediatrics
|August 9, 2023
Summary
Comorbid physical and mental illnesses are common in adolescents and young adults, significantly increasing their emergency department visits and hospitalizations.
Area of Science:
- Adolescent and Young Adult (AYA) Health
- Chronic Illness Epidemiology
- Mental Health Services Research
Background:
- Adolescents and young adults (AYA) experience a range of chronic physical and mental illnesses.
- Comorbidity between physical and mental health conditions is a significant concern in this age group.
- Understanding the impact of these comorbidities on healthcare utilization is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of chronic physical illnesses and mental illness among AYA.
- To investigate the comorbidity rates between physical and mental health conditions in AYA.
- To assess how comorbidity influences hospital utilization, including emergency department (ED) visits and inpatient hospitalizations.
Main Methods:
- Utilized a population-level dataset of 49,089 insurance-eligible AYA (aged 12-21) from Vermont's 2018 all-payer database.
- Employed multiple logistic regression analyses to examine associations between physical illness types, comorbid mental illness, and healthcare utilization.
- Controlled for demographic factors and insurance status in the analysis.
Main Results:
- Mental illness was prevalent (31%) and frequently comorbid with various physical illnesses in the AYA sample.
- Comorbid mental illness was significantly associated with increased odds of ED use and hospitalization across multiple physical illness categories.
- For instance, AYA with pulmonary illness and comorbid mental illness had 1.74 times greater odds of ED use and 2.9 times greater odds of hospitalization.
Conclusions:
- Comorbid physical and mental illnesses are common among adolescents and young adults.
- The presence of comorbid mental illness substantially increases the likelihood of emergency department visits and inpatient hospitalizations.
- These findings highlight the need for integrated care models to address the complex health needs of AYA with comorbid conditions.
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