by Elana Gotkine

Children with medical complexity (CMC) often have neurodevelopmental and mental health diagnoses, which are associated with increased health care utilization, according to a study published online Aug 5 in Pediatrics.

JoAnna K. Leyenaar, M.D., Ph.D., M.P.H., from the Children's Hospital at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, and colleagues identified neurodevelopmental and mental health diagnoses using all-payer claims data from three states for 2012 to 2017. Outcomes for CMC with neurodevelopmental and mental health diagnoses were compared to CMC without these diagnoses, adjusting for sociodemographic and clinical characteristics.

Of the 85,581 CMC, 45.6 and 37.0% had one or more neurodevelopmental diagnoses and one or more mental health diagnoses, respectively, reflecting corresponding adjusted relative risks of 3.46 and 2.22 compared with children without medical complexity.

The researchers found that compared with CMC without these diagnoses, CMC with both neurodevelopmental and mental health diagnoses had 3.00 times the number of ambulatory visits, more emergency department visits (rate ratio, 1.69), an elevated risk for hospitalization (rate ratio, 1.58), and 2.32 times the number of hospital days.

"These findings illustrate the importance of recognizing and treating neurodevelopmental and mental health conditions in this population," the authors write. "Investment in evidence-based strategies to prevent, diagnose, and treat mental health conditions in CMC is needed."

More information: JoAnna K. Leyenaar et al, Neurodevelopmental and Mental Health Conditions in Children With Medical Complexity, Pediatrics (2024). DOI: 10.1542/peds.2024-065650

Nicolas M. Oreskovic et al, Complexity Plus: The Importance of Co-Occurring Conditions in Children With Medical Complexity, Pediatrics (2024). DOI: 10.1542/peds.2024-067259

Journal information: Pediatrics 

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