title: Behavioral Health Problems Presented to Integrated Pediatric Behavioral Health Clinics: Differences in Urban and Rural Patients.
abstract: Behavioral health diagnoses and service use may differ based on rurality. The purpose of this study was to examine the patterns of mental disorder diagnoses of urban, rural, and remote pediatric populations. This retrospective study used electronic medical records from integrated behavioral health clinics in Nebraska from 2012 to 2013. Bivariate and multivariable models were used to examine the differences in diagnoses. Adolescents with attention deficit and related disorders were more likely to be male, younger, have public insurance and rural/remote residents. Adjustment disorders were associated with being female, older, and urban residents. Adolescents with anxiety disorder had a significant interaction between age and gender, with both genders being older, having private insurance, and urban residents. Adolescents with mood disorder were more likely to be female, older, and urban residents. Demographic and clinical differences among patients in urban and rural/remote settings have implications for care in rural settings.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA. swatanabe@unmc.edu.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Watanabe-Galloway
authors.affiliation: Department of Psychology, Munroe-Meyer Institute, University of Nebraska Medical Center, 985450 Nebraska Medical Center, Omaha, NE, 68198-5450, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Valleley
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Rieke
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Corley
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders; D009329:Nebraska; D012189:Retrospective Studies; D012424:Rural Population; D014505:Urban Population
keywords: Adolescent; Emotional and behavioral problems; Integrated behavioral/primary care; Pediatric