Psychopathology as a Predictor of Medical Service Utilization for Youth in Residential Treatment
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Rising health care costs have led to an emphasis on identifying factors that contribute to medical service utilization. Previous research has suggested an association between youth psychopathology and service utilization; however, prospective studies among high-risk populations are needed. The current study examined youth psychopathology as a predictor of subsequent medical service utilization among a large sample (N = 536) of youth entering residential treatment. Youth psychopathology and medical status were assessed at intake, and medical service utilization was tracked across the duration of the residential placement. Results indicated that higher levels of psychopathology predicted greater youth medical service utilization, even after controlling for the presence of a diagnosed medical condition. Internalizing problems was a significant independent predictor of utilization, but externalizing problems was not. These findings highlight the association between mental health and medical service utilization and suggest that effective behavioral health services may be helpful in reducing costly medical service needs.
- Bodenheimer T. High and rising health care costs: Part 1. Seeking an explanation. Annals of Internal Medicine 2005; 142(10): 847–854.
- Shenkman E, Knapp C, Sappington D, et al. Persistence of high health care expenditures among children in Medicaid. Medical Care Research and Review 2007; 64(3): 304–330. CrossRef
- Starfield B, van den Berg BJ, Steinwachs DM, et al. Variations in utilization of health services by children. Pediatrics 1979(4); 63: 633–641.
- Ireys HT, Anderson GF, Shaffer TJ, et al. Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid Program, fiscal year 1993. Pediatrics 1997; 100: 197–204. CrossRef
- McCormick MC, Weinick RM, Elixhauser A, et al. Annual report on access to and utilization of health care for children and youth in the United States—2000. Ambulatory Pediatrics 2001; 1(1): 3–15. CrossRef
- Liptak GS, Shone LP, Auinger P, et al. Short-term persistence of high health care costs in a nationally representative sample of children. Pediatrics 2006; 118(4): e1001–e1009. CrossRef
- Finney JW, Riley AW, Cataldo MF. Psychology in primary health care: Effects of brief targeted therapy on children’s medical care utilization. Journal of Pediatric Psychology 1991; 16(4): 447–461. CrossRef
- Jones D, Godwin J, Dodge KA, et al. Impact of the Fast Track prevention program on health services use by conduct-problem youth. Pediatrics 2010; 125(1): 130–136. CrossRef
- Fact sheet: Behavioral management and children in residential care. Child Welfare League of America. Available online at www.cwla.org/advocacy/secresfactsheet.htm. Accessed September 10, 2011.
- Nelson TD, Smith TR, Thompson RW, et al. Prevalence of physical health problems among youth entering residential treatment. Pediatrics 2011; 128, e1226–1232. CrossRef
- Drais-Parrillo AA. The Odyssey Project: A descriptive and prospective study of children and youth in residential group care and therapeutic foster care. Washington, DC: Child Welfare League of America, 2004.
- Duppong Hurley K, Trout A, Chmelka MB, et al. The changing mental health needs of youth admitted to residential group home care: Comparing mental health status at admission in 1995 and 2004. Journal of Emotional and Behavioral Disorders 2009; 17: 1640 176.
- Handwerk ML, Clopton K, Huefner JC, et al. Gender differences in adolescents in residential treatment. American Journal of Orthopsychiatry 2006; 76: 312–324. CrossRef
- Griffith AK, Ingram SD, Barth RP, et al. The family characteristics of youth entering a residential care program. Residential Treatment for Children and Youth 2009; 26: 135–150. CrossRef
- Halfon N, Berkowitz G, Klee L. Children in foster care in California: An examination of Medicaid reimbursed health services utilization. Pediatrics 1992; 89: 1230–1237.
- Rubin DM, Alessandrini EA, Feudtner C, et al. Placement changes and emergency department visits in the first year of foster care. Pediatrics 2004; 114(3): e354–e360. CrossRef
- Angel RJ, Angel JL. Physical comorbidity and medical care use in children with emotional problems. Public Health Reports 1996; 111: 140–145.
- Newacheck PW, Kim SE. A national profile of health care utilization and expenditures for children with special health care needs. Archives of Pediatric Adolescent Medicine 2003; 159: 10–17. CrossRef
- Simpson L, Owens PL, Zodet M, et al. Health care for children and youth in the United States: Annual report of patterns of coverage, utilization, quality, and expenditures by income. Ambulatory Pediatrics 2005; 1(5): 6–44. CrossRef
- Shatin D, Levin R, Ireys HT, et al. Health care utilization by children with chronic illnesses: A comparison of Medicaid and employer insured managed care. Pediatrics 1998; 102(4): 1–9. CrossRef
- Weller WE, Minkovitz CS, Anderson GF. Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data). Pediatrics 2003; 112(3): 593–603. CrossRef
- Bernal P, Bendell Estroff D, Aboudarham JF, et al. The economic burden in a pediatric health maintenance organization sample. Archives of Pediatric Adolescent Medicine 2000; 154: 261–266.
- Lozano P, Fishman P, VonKorff M, et al. Health care utilization and cost among children with asthma who were enrolled in a health maintenance organization. Pediatrics 1997; 99: 757–764. CrossRef
- Barsky AJ, Wyshak G, Klerman GL. Medical and psychiatric determinants of outpatient medical utilization. Medical Care 1986; 24(6): 548–560. CrossRef
- Zuckerman B, Moore KA, Glei D. Association between child behavior problems and frequent physician visits. Archives of Pediatric and Adolescent Medicine 1996; 150: 146–153. CrossRef
- Lavigne JV, Binns HJ, Arend R, et al. Psychopathology and health care use among preschool children: A retrospective analysis. Journal of the American Academy of Child and Adolescent Psychiatry 1998; 37(3): 262–270. CrossRef
- Cuffe SP, Moore CG, McKeown R. ADHD and health services utilization in the national health interview survey. Journal of Attention Disorders 2009: 12(4): 330–340. CrossRef
- Guevara J, Lozano P, Wickizer T, et al. Utilization and cost of health care services for children with attention-deficit/hyperactivity disorder. Pediatrics 2001; 108(1): 71–78. CrossRef
- Peng C, Hatlestad P, Klug MG, et al. Health cost and utilization rates for children and pervasive developmental disorders in North Dakota from 1998 to 2004: Impact on Medicaid. Journal of Child Neurology 2009; 24(2): 140–147. CrossRef
- McIntyre RS, Konarski JZ, Soczynska JK. Medical comorbidity in bipolar disorder: Implication for functional outcomes and health service utilization. Psychiatric Services 2006; 57(8): 1140–1144. CrossRef
- Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families, 2001.
- International statistical classification of diseases and related health problems, Tenth Revision (ICD-10) [online application]. World Health Organization. Available online at http://apps.who.int/classifications/apps/icd/icd10online/. Accessed September 10, 2011.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association, 2000.
- Herbert TB, Cohen S. Stress and immunity in humans: A meta-analytic review. Psychosomatic Medicine 1993; 55: 364–379.
- Segerstrom SC, Miller GE. Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin 2004; 130(4): 601–630. CrossRef
- Vernberg EM, Nelson TD, Fonagy P, et al. Victimization, aggression, and visits to the school nurse for somatic complaints, illnesses, and physical injuries. Pediatrics 2011; 127: 842–848. CrossRef
- Psychopathology as a Predictor of Medical Service Utilization for Youth in Residential Treatment
The Journal of Behavioral Health Services & Research
Volume 40, Issue 1 , pp 36-45
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Author Affiliations
- 1. Department of Psychology, University of Nebraska–Lincoln, 319 Burnett Hall, Lincoln, NE, 6858 8-0308, USA
- 2. Boys Town Nebraska/Iowa Region, Boys Town, NE, USA
- 3. Center for Child and Family Well-Being, University of Nebraska–Lincoln, Lincoln, NE, USA
- 4. Boys Town National Research Institute, Boys Town, NE, USA
- 5. Boys Town Institute for Child Health Improvement, Boys Town, NE, USA