Abstract
IntroductionThe prevalence of chronic physical and mental disorders is increasing among children and adolescents in the United States. In this study, we investigated the association between mental health disorders and chronic physical conditions among children, and we assessed whether having mental disorders is associated with increased health care costs for children with chronic physical conditions, using Medical Expenditure Panel Survey data from 2008 through 2013.MethodsChildren aged 5 to 17 with at least 1 chronic physical condition were included in the study. Chronic physical conditions and mental disorders were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. We used logistic regression to assess the relationship between mental disorders and chronic physical conditions, and we used generalized linear models with gamma distribution and log link to estimate direct medical costs.ResultsOf 42,130 children, 4,640 had at least 1 chronic physical condition. After controlling for sociodemographic and health care access characteristics, we found that children with at least 1 chronic physical condition were 62% more likely to have a mental health disorder than were children without chronic physical conditions (odds ratio = 1.62; 95% confidence interval [CI], 1.37–1.92). Having a mental disorder was a significant predictor of total health care cost (β = 0.64; 95% CI, 0.43–0.85; P < .001). The adjusted annual incremental cost due to mental disorders among children with chronic physical conditions was $2,631 (P < .001).ConclusionHaving chronic physical conditions in childhood is a significant predictor of mental health disorders and total health care expenditures.
Highlights
The prevalence of chronic physical and mental disorders is increasing among children and adolescents in the United States
After controlling for sociodemographic and health care access characteristics, we found that children with at least 1 chronic physical condition were 62% more likely to have a mental health disorder than were children without chronic physical conditions
Having a mental disorder was a significant predictor of total health care cost (β = 0.64; 95% CI, 0.43–0.85; P < .001)
Summary
We investigated the association between mental health disorders and chronic physical conditions among children, and we assessed whether having mental disorders is associated with increased health care costs for children with chronic physical conditions, using Medical Expenditure Panel Survey data from 2008 through 2013. During the past 50 years, the prevalence of chronic conditions among children has risen steadily in the United States. Many children with chronic physical illness are reaching adulthood. These children must adapt to their illness and cope with the difficulties and stresses inherent in living with chronic physical disorders. Chronic stress can precipitate into various adjustment, emotional, and behavioral disorders among children, resulting in poor academic performance, which may adversely affect their employment success when they reach adulthood [3,4]
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