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Individuals with spina bifida (SB) face higher risks for last-resort behavioral health care (LRBH) utilization. Sociodemographic factors influence LRBH access within the SB population, highlighting needs for targeted interventions.

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Area of Science:

  • Public Health
  • Health Services Research
  • Clinical Medicine

Background:

  • Spina bifida (SB) is a complex congenital condition often associated with significant healthcare needs.
  • Understanding behavioral health care utilization patterns is crucial for individuals with SB.

Purpose of the Study:

  • To compare last-resort behavioral health care (LRBH) utilization for mental health and substance use disorders between individuals with spina bifida (SB) and matched non-SB controls.
  • To identify predictors of LRBH utilization within the SB population.

Main Methods:

  • Analysis of California Department of Health Care Access and Information data (2005-2017).
  • Comparison of inpatient and emergency department (ED) behavioral health utilization between individuals with SB and matched non-SB controls (1:5 ratio).
  • Multivariable logistic regression to assess LRBH use likelihood, adjusting for covariates.

Main Results:

  • Individuals with SB exhibited higher LRBH encounters (5.1 vs. 2.7 per patient) and an independently associated increased risk (aOR 1.49).
  • Within the SB group, higher comorbidity, female sex, and non-private insurance predicted increased utilization.
  • Certain racial/ethnic groups and lower socioeconomic status areas were associated with decreased odds of care.

Conclusions:

  • Individuals with SB have a significantly higher risk of LRBH utilization compared to controls.
  • Sociodemographic factors are significant predictors of LRBH care within the SB population.
  • Findings suggest a need for preventive behavioral health interventions targeting identified risk factors in the SB population.