Meta 分析：儿童心理健康与儿科医疗保健利用的关系。

Meta-Analysis: Association of Parent and Child Mental Health with Pediatric Health Care Utilization.

机构信息

Feinberg School of Medicine, Northwestern University.

出版信息

J Pediatr Psychol. 2019 Oct 1;44(9):1097-1110. doi: 10.1093/jpepsy/jsz049.

DOI:10.1093/jpepsy/jsz049

PMID:31233147

Abstract

OBJECTIVE

To examine the association of psychological factors and pediatric health care utilization.

METHOD

Ovid Medline and PsychInfo were searched and archival and forward searchers were conducted of relevant articles. Studies of the association between psychological risk factors and pediatric health care utilization of outpatient services, emergency department, inpatient length of stay, and costs were identified. Effect sizes were expressed in the form of the standardized mean difference. From 4,546 studies identified in the search, 69 studies met inclusion criteria.

RESULTS

There were significant low-moderate associations between higher outpatient visits and general child mental health (MH) problems (mean ES [mES] = 0.35), overall psychopathology (mES = 0.44), and internalizing symptoms (mES = 0.16). Results were significant for any parent MH problem (mES = 0.18). For emergency department (ED) visits, there were significant association between more ED visits and any child MH problems (mES = 0.25), internalizing symptoms (mES = 0.24), externalizing symptoms (mES = 0.16), and Attention Deficit/Hyperactivity Disorder (mES= 0.14), as well as parent MH (mES = 0.24) and maternal depression (mES = 0.21). Increased hospitalizations were associated with any child MH problem (mES = 0.3), overall child psychopathology (mES = 0.49), child depression (ES = 0.41), and any parent MH problem (mES = 0.54). For costs, results were significant for any child MH problem (mES = 0.38).

CONCLUSIONS

Child and parent MH problems are significantly associated with increased HCU.

摘要

目的

研究心理因素与儿科医疗保健利用之间的关系。

方法

检索 Ovid Medline 和 PsychInfo，并对相关文章进行档案和追溯检索。确定了研究心理风险因素与儿科门诊服务、急诊科、住院时间和费用利用之间关系的研究。以标准化均数差的形式表示效应大小。在搜索中确定了 4546 项研究，其中 69 项符合纳入标准。

结果

较高的门诊就诊次数与一般儿童心理健康（MH）问题（mES = 0.35）、整体精神病理学（mES = 0.44）和内化症状（mES = 0.16）之间存在显著的低中度关联。任何父母的 MH 问题（mES = 0.18）都有显著的结果。对于急诊科就诊次数，更多的急诊科就诊次数与任何儿童 MH 问题（mES = 0.25）、内化症状（mES = 0.24）、外化症状（mES = 0.16）和注意力缺陷/多动障碍（mES = 0.14）以及父母 MH（mES = 0.24）和母亲抑郁（mES = 0.21）存在显著关联。住院时间增加与任何儿童 MH 问题（mES = 0.3）、整体儿童精神病理学（mES = 0.49）、儿童抑郁（mES = 0.41）和任何父母 MH 问题（mES = 0.54）有关。对于费用，任何儿童 MH 问题（mES = 0.38）的结果均有显著意义。