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Neurodevelopmental and Mental Health Conditions in Children With Medical Complexity

JoAnna K Leyenaar1,2, Mary Arakelyan1, Andrew P Schaefer2

  • 1Department of Pediatrics, Children's Hospital at Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Pediatrics
|August 5, 2024
PubMed

Insights

Neurodevelopmental and mental health diagnoses are common in children with medical complexity (CMC), significantly increasing their healthcare use. Early recognition and treatment of these conditions in CMC are crucial for better outcomes.

Area of Science:

  • Pediatric Health
  • Neurodevelopmental Disorders
  • Mental Health Conditions

Background:

  • Children with medical complexity (CMC) face heightened risks for neurodevelopmental and mental health issues due to comorbidities and unique life experiences.
  • Population-level data on the prevalence of these conditions in CMC remains limited.
  • Understanding these prevalence rates is critical for targeted interventions.

Purpose of the Study:

  • To estimate the prevalence of neurodevelopmental and mental health diagnoses in CMC compared to children without medical complexity.
  • To examine the association between these diagnoses in CMC and subsequent healthcare utilization and in-hospital mortality.

Main Methods:

  • Utilized all-payer claims data from three states (2012-2017).
  • Applied the Child and Adolescent Mental Health Disorders Classification System for diagnosis identification.
  • Employed Poisson regression to compare outcomes, adjusting for sociodemographic and clinical factors.

Main Results:

  • 45.6% of CMC had neurodevelopmental diagnoses; 37.0% had mental health diagnoses.
  • CMC with these diagnoses showed significantly higher relative risks compared to children without medical complexity.
  • CMC with both types of diagnoses experienced substantially increased healthcare utilization, including ambulatory visits, emergency department visits, hospitalizations, and hospital days.

Conclusions:

  • Neurodevelopmental and mental health diagnoses are highly prevalent in CMC.
  • These diagnoses are strongly associated with increased healthcare utilization across all care settings.
  • Emphasizes the critical need for identifying and managing these conditions in the CMC population.
Abstract

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