The association of psychiatric diagnoses, health service use, and expenditures in children with obesity-related health conditions.
OBJECTIVE
To examine the association of psychiatric diagnoses and use of health care services in children with obesity-related health conditions.


METHODS
A retrospective, longitudinal design was used to examine Medicaid claims data. The data set consisted of 13,688 youth diagnosed with type 2 diabetes, metabolic syndrome, dyslipidemia, or obesity.


RESULTS
The presence of any type of psychiatric diagnosis was associated with higher health service use. In particular, the presence of an internalizing diagnosis was more consistently associated with higher service use than the presence of an externalizing diagnosis. Children with both an externalizing and internalizing disorder diagnosis had greater service use than children with a diagnosis in only one of these categories.


CONCLUSIONS
These data highlight a subgroup of children with obesity-related health conditions who are at greater risk for higher health service use, and the need for further research on the association between psychiatric diagnosis and health service use.
Janicke
David M
DM
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610, USA. djanicke@phhp.ufl.edu
Harman
Jeffrey S
JS
Kelleher
Kelly J
KJ
Zhang
Jianyi
J
D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000191:economics / Q000453:epidemiology; D002675:Child, Preschool; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D005431:Florida; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000191:economics* / Q000453:epidemiology*; D007389:Internal-External Control; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000191:economics* / Q000453:epidemiology*; D009765:Obesity / Q000191:economics* / Q000453:epidemiology*; D012189:Retrospective Studies; D014481:United States