Parental mental and pain-related health and pediatric ambulatory care sensitive emergency department visits and hospitalizations.
OBJECTIVE
To investigate the types of parental psychiatric and pain-related (PR) conditions that are associated with inadequate management of children's health and medical needs.


METHODS
The 1997-1998 Thomson/Medstat MarketScan claims and administrative dataset.


METHODS
A cross-sectional study that assessed the associations between parents' claims for psychiatric and PR conditions, and their children's well-child care as well as emergency department (ED) visits and hospitalizations for conditions that can be treated effectively in outpatient settings (ambulatory care sensitive [ACS] conditions).


METHODS
Claims were extracted for 258,313 children of ages 0-17 years and their parents, who had insurance coverage for a full 2-year period.


RESULTS
Multiple parental psychiatric and PR diagnoses were associated with child ACS emergency services/hospitalizations. Maternal depression was negatively associated with a child having the recommended well-child visits (odds ratio [OR]: 0.92, 95 percent confidence intervals [CI]: 0.84-0.99). The combined diagnoses of maternal depression and back pain was positively associated with a child having an ACS-ED visit (OR: 1.64, 95 percent CI: 1.33-2.03) and a child having an ACS hospitalization (OR: 2.04, 95 percent CI: 1.34-3.09).


CONCLUSIONS
Pediatricians' ability to manage child health may be enhanced with coordinated management of parental psychopathology and PR health conditions.
Logan
Joseph E
JE
Division of Violence Prevention, Etiology and Surveillance Branch, The Centers for Disease Control and Prevention, 4770 Buford Highway, MS-K60, Atlanta, GA 30341-3724, USA.
Riley
Anne W
AW
Barker
Lawrence E
LE
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001416:Back Pain / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005220:Fathers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D011320:Primary Health Care / Q000706:statistics & numerical data; D012111:Residence Characteristics