RESUMEN
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.
Asunto(s)
Enfermedad Crónica/economía , Costo de Enfermedad , Sistemas Prepagos de Salud/economía , Trastornos Psicofisiológicos/economía , Trastornos Somatomorfos/economía , Adolescente , California/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Mal Uso de los Servicios de Salud/economía , Mal Uso de los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Trastornos Psicofisiológicos/epidemiología , Trastornos Somatomorfos/epidemiología , Revisión de Utilización de RecursosRESUMEN
The impact of ethnicity on word fluency measures, i.e., the FAS (Benton & Hamsher, 1976) and Animal Naming (AN) (Spreen & Strauss, 1991) tests, was explored. The groups included: White (n = 200), Black (n = 200), and Hispanic (n = 200) veterans. Multivariate analysis of variance (MANOVA) revealed significant main effects for FAS and AN total scores both before and after covarying for income, education, and Wide Range Achievement Test-Revised Reading scores (p <.05). The largest unadjusted group mean difference approximated a medium effect size. No differences were found between FAS and AN standardized scores within each group. The findings are discussed as they relate to clinical practice and research.