Psychosocial morbidity: the economic burden in a pediatric health maintenance organization sample

Arch Pediatr Adolesc Med. 2000 Mar;154(3):261-6. doi: 10.1001/archpedi.154.3.261.


Objectives: To evaluate psychosocial morbidity in pediatric primary care and to determine displaced health care utilization.

Design and setting: A cross-sectional sample of parent-child dyads was screened using the Pediatric Symptom Checklist (PSC) at 6 pediatric sites of a health maintenance organization (HMO). Cost and utilization data were retrieved from regional databases for this sample.

Participants: Parent-child dyads from an HMO in northern California (N = 1840). The children ranged in age from 2 to 18 years.

Results: In all, 13.0% of children exhibited psychosocial dysfunction. The rate of children's chronic illness was 18.4%. Multiple regression analyses measured utilization and cost of health and psychiatric care for the selected population for the previous year; the average log cost of health care per child was $393. The average health care cost for children with anxious, depressed symptoms was $805. Chronically ill children were the highest utilizers of health care, with an average log cost of $1138. When psychosocial dysfunction was present, regression models showed that health care spending was highest for young children.

Conclusions: Health care utilization was higher for children with psychosocial morbidity, was higher among younger children, and decreased with age as psychiatric costs progressively increased.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • California / epidemiology
  • Child
  • Child, Preschool
  • Chronic Disease / economics*
  • Cost of Illness*
  • Cross-Sectional Studies
  • Female
  • Health Maintenance Organizations / economics*
  • Health Services Misuse / economics
  • Health Services Misuse / statistics & numerical data
  • Humans
  • Male
  • Psychophysiologic Disorders / economics*
  • Psychophysiologic Disorders / epidemiology
  • Somatoform Disorders / economics*
  • Somatoform Disorders / epidemiology
  • Utilization Review