Association between parental depression and children's health care use.

  • MR S
  • Shetterly S
  • Xu S
 et al. 
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Abstract

OBJECTIVE: The objective of this study was to determine the association between parental depression and pediatric health care use patterns. METHODS: We selected all children who were 0 to 17 years of age, enrolled in Kaiser Permanente of Colorado during the study period July 1997 to December 2002, and linked to at least 1 parent/subscriber who was enrolled for at least 6 months during that period. Unexposed children were selected from a pool of children whose parents did not have a depression diagnosis. Outcome measures were derived from the child's payment files and electronic medical charts and included 5 categories of use: well-child-care visits, sick visits to primary care departments, specialty clinic visits, emergency department visits, and inpatient visits. We compared the rate of use per enrollment month for these 5 categories between exposed and unexposed children within each of the 5 age strata. RESULTS: Our study population had 24,391 exposed and 45,274 age-matched, unexposed children. For the outcome of well-child-care visits, teenagers showed decreased rates of visits among exposed children. The rate of specialty department visits was higher in exposed children in the 4 oldest age groups. The rates of both emergency department visits and sick visits to primary care departments were higher for exposed children across all 5 age categories. The rate of inpatient visits was higher among exposed children in 2 of the 5 age groups. CONCLUSIONS: Overall, having at least 1 depressed parent is associated with greater rate of emergency department and sick visits across all age groups, greater use of inpatient and specialty services in some age groups, and a lower rate of well-child-care visits among 13- to 17-year-olds. This pattern of increased use of expensive resources and decreased use of preventive services represents one of the hidden costs of adult depression.

Author-supplied keywords

  • Adolescence
  • Bivariate Statistics
  • Case Control Studies
  • Chi Square Test
  • Child
  • Child Health Services -- Utilization
  • Child, Preschool
  • Colorado
  • Data Analysis Software
  • Depression -- Diagnosis
  • Depression -- Epidemiology
  • Emergency Service -- Utilization
  • Family Practice
  • Female
  • Fisher's Exact Test
  • Funding Source
  • Health Care Delivery
  • Human
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Office Visits -- Utilization
  • Parent-Child Relations
  • Poisson Distribution
  • Retrospective Design
  • Wilcoxon Rank Sum Test

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Authors

  • Sills MR

  • S Shetterly

  • S Xu

  • D Magid

  • A Kempe

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