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

Objectives. 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((R)) 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. Principal Finding. 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.