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Journal of Pediatric Psychology Advance Access published online on June 3, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn051
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The Association of Psychiatric Diagnoses, Health Service Use, and Expenditures in Children with Obesity-related Health Conditions

David M. Janicke, PhD1, Jeffrey S. Harman, PhD2, Kelly J. Kelleher, MD, MPH3 and Jianyi Zhang, PhD4

1Department of Clinical and Health Psychology, 2Department of Health Services Research, Management and Policy, University of Florida, 3Department of Pediatrics and Public Health, Children's Hospital, and 4University of Florida Center for Medicaid and the Uninsured, University of Florida

All correspondence concerning this article should be addressed to David M. Janicke, PhD, Department of Clinical and Health Psychology, PO Box 100165, University of Florida, Gainesville, FL 32610, USA. E-mail: djanicke{at}phhp.ufl.edu


  Abstract

Objective To examine the association of psychiatric diagnoses and use of health care services in children with obesity-related health conditions. Method 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.

Key words: children; diabetes; dyslipidemia; health service use; metabolic syndrome; obesity; psychiatric diagnosis.

Received February 12, 2008; revision received May 3, 2008; accepted May 3, 2008


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