Parental mental and pain-related health and pediatric ambulatory care sensitive emergency department visits and hospitalizations

Health Serv Res. 2008 Apr;43(2):656-74. doi: 10.1111/j.1475-6773.2007.00790.x.


Objective: To investigate the types of parental psychiatric and pain-related (PR) conditions that are associated with inadequate management of children's health and medical needs.

Data sources: The 1997-1998 Thomson/Medstat MarketScan claims and administrative dataset.

Study design: A cross-sectional study that assessed the associations between parents' claims for psychiatric and PR conditions, and their children's well-child care as well as emergency department (ED) visits and hospitalizations for conditions that can be treated effectively in outpatient settings (ambulatory care sensitive [ACS] conditions).

Data extraction methods: Claims were extracted for 258,313 children of ages 0-17 years and their parents, who had insurance coverage for a full 2-year period.

Principle findings: Multiple parental psychiatric and PR diagnoses were associated with child ACS emergency services/hospitalizations. Maternal depression was negatively associated with a child having the recommended well-child visits (odds ratio [OR]: 0.92, 95 percent confidence intervals [CI]: 0.84-0.99). The combined diagnoses of maternal depression and back pain was positively associated with a child having an ACS-ED visit (OR: 1.64, 95 percent CI: 1.33-2.03) and a child having an ACS hospitalization (OR: 2.04, 95 percent CI: 1.34-3.09).

Conclusions: Pediatricians' ability to manage child health may be enhanced with coordinated management of parental psychopathology and PR health conditions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care / statistics & numerical data*
  • Back Pain / epidemiology
  • Back Pain / psychology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Emergency Service, Hospital / statistics & numerical data*
  • Fathers / psychology*
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Middle Aged
  • Mothers / psychology*
  • Pain / epidemiology*
  • Pain / psychology
  • Primary Health Care / statistics & numerical data
  • Residence Characteristics