The Robert Larner, M.D. College of Medicine.
Department of Pediatrics.
Hosp Pediatr. 2023 Sep 1;13(9):841-848. doi: 10.1542/hpeds.2022-006984.
Characterize the prevalence of chronic physical illness types and mental illness and their comorbidity among adolescents and young adults (AYA) and assess the association of comorbidity on hospital utilization.
This study features a population-level sample of 61 339 insurance-eligible AYA with an analytic sample of 49 089 AYA (aged 12-21) in Vermont's 2018 all-payer database. We used multiple logistic regressions to examine the associations between physical illness types and comorbid mental illness and emergency department (ED) use and inpatient hospitalization.
The analytic sample was 50% female, 63% Medicaid, and 43% had ≥1 chronic illness. Mental illness was common (31%) and highly comorbid with multiple physical illnesses. Among AYA with pulmonary illness, those with comorbid mental illness had 1.74-times greater odds (95% confidence interval [CI]: 1.49-2.05, P ≤.0005) of ED use and 2.9-times greater odds (95% CI: 2.05-4.00, P ≤.0005) of hospitalization than those without mental illness. Similarly, comorbid endocrine and mental illness had 1.84-times greater odds of ED use (95% CI: 1.39-2.44, P ≤.0005) and 2.1-times greater odds of hospitalization (95% CI: 1.28-3.46, P = .003), comorbid neurologic and mental illness had 1.36-times greater odds of ED use (95% CI: 1.18-1.56, P ≤.0005) and 2.4-times greater odds of hospitalization (95% CI: 1.73-3.29, P ≤.0005), and comorbid musculoskeletal and mental illness had 1.38-times greater odds of ED use (95% CI: 1.02-1.86, P = .04) and 2.1-times greater odds of hospitalization (95% CI: 1.20-3.52, P = .01).
Comorbid physical and mental illness was common. Having a comorbid mental illness was associated with greater ED and inpatient hospital utilization across multiple physical illness types.
描述青少年和年轻成年人（AYA）中慢性躯体疾病类型和精神疾病的流行情况及其共病情况，并评估共病对住院利用的影响。
本研究以佛蒙特州 2018 年全支付者数据库中符合保险条件的 61339 名 AYA 的人群水平样本为特色，并对其中 49089 名 AYA（年龄 12-21 岁）进行了分析样本。我们使用多变量逻辑回归来研究躯体疾病类型与共患精神疾病以及急诊科（ED）使用和住院之间的关联。
分析样本中 50%为女性，63%为医疗补助，43%有≥1 种慢性疾病。精神疾病很常见（31%），且与多种躯体疾病高度共病。在患有肺部疾病的 AYA 中，患有共患精神疾病的患者 ED 使用的可能性高 1.74 倍（95%置信区间[CI]：1.49-2.05，P ≤.0005），住院的可能性高 2.9 倍（95%CI：2.05-4.00，P ≤.0005）。同样，内分泌和精神共病的 ED 使用可能性高 1.84 倍（95%CI：1.39-2.44，P ≤.0005），住院可能性高 2.1 倍（95%CI：1.28-3.46，P =.003），神经和精神共病的 ED 使用可能性高 1.36 倍（95%CI：1.18-1.56，P ≤.0005），住院可能性高 2.4 倍（95%CI：1.73-3.29，P ≤.0005），肌肉骨骼和精神共病的 ED 使用可能性高 1.38 倍（95%CI：1.02-1.86，P =.04），住院可能性高 2.1 倍（95%CI：1.20-3.52，P =.01）。
共患躯体和精神疾病很常见。患有共患精神疾病与多种躯体疾病的 ED 和住院利用率增加有关。
