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Incidence of pediatric chronic tic disorders and feasibility of using the Massachusetts All-Payer Claims Database,
Marisela E Dy-Hollins1, Mamoon Habib1, Erika F Augustine2
1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Insights
The Massachusetts All-Payer Claims Database can identify children with chronic tic disorders. This study found it feasible for tracking pediatric tic disorder incidence.
Area of Science:
- Pediatric Neurology
- Public Health Surveillance
- Health Informatics
Background:
- Chronic tic disorders affect nearly 1.5 million US children, often with co-occurring neuropsychiatric conditions.
- These complex childhood-onset conditions involve involuntary movements or sounds and are under-recognized.
- Comorbidity with neuropsychiatric illness is common in pediatric chronic tic disorders.
Purpose of the Study:
- To assess the feasibility of using the Massachusetts All-Payer Claims Database (MA-APCD) for identifying new cases of chronic tic disorders.
- To determine if claims data can effectively capture the incidence of pediatric tic disorders.
- To establish a foundation for future research on care access and quality for chronic tic disorders.
Main Methods:
- Retrospective analysis of the 2012-2016 MA-APCD.
- Inclusion criteria: pediatric participants (4-18 years) with continuous insurance (2013-2016).
- Incident tic disorder diagnosis defined as the first ICD-9/ICD-10 code for tic disorders within the study period, with no prior diagnosis.
Main Results:
- Over 1.6 million claims were analyzed; 1,258 claims indicated an incident tic disorder diagnosis.
- The average age at diagnosis was 9.7 years (±3.5).
- The pediatric population diagnosed with tic disorders was predominantly male (74.5%) and covered by Medicaid (64.8%).
Conclusions:
- The MA-APCD is a feasible resource for studying the incidence of chronic tic disorders in children.
- This methodology supports future investigations into healthcare access and quality for pediatric tic disorder patients.
- The findings highlight the utility of large-scale claims databases for epidemiological research in child neurology.
Background:
Nearly 1.5 million children in the United States have a chronic tic disorder, an under-recognized childhood-onset complex chronic condition characterized by involuntary movements and/or sounds, that is often comorbid with neuropsychiatric illness. This study sought to examine the feasibility of using the Massachusetts All-Payer Claims Database to identify incident cases of chronic tic disorders.
Methods:
In this retrospective analysis using the 2012-2016 Massachusetts All-Payer Claims Database, participants 4-18 years of age with health insurance for at least one year between 1/1/2013-12/31/2016 were included. Incident tic disorder diagnosis was defined as the first observed ICD-9/ICD-10 code for tic disorders with no diagnosis claim in the prior 12 months (e.g., Tourette Syndrome: 307.23, F95.2). Age at diagnostic encounter, sex, and insurance type were examined for those with an incident tic diagnosis.
Results:
Between 2012-2016, there were 1,638,691 unique claims for individuals aged 4-18 years. Of these, 1,258 unique claims had an incident tic disorder diagnosis. The mean age (± standard deviation) at diagnostic encounter was 9.7±3.5 years. Participants were predominantly male (74.5%) and had Medicaid coverage (64.8%).
Conclusions:
The Massachusetts All-Payer Claims Database is feasible to examine the incidence of chronic tic disorders in a pediatric population. Future studies will examine access to and quality of care in chronic tic disorders.
