Neuro/psychological diagnoses are common in children with medical complexity

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

JoAnna K. Leyenaar, MD, PhD, MPH, of the Children’s Hospital of 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 psychiatric diagnoses, respectively, corresponding to 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 disorders and mental health conditions had 3.00 times as many outpatient visits, more emergency department visits (ratio 1.69), an increased risk of hospitalization (ratio 1.58), and 2.32 times as many hospital days.

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

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