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首页> 外文学位 >Impact of mental health diagnosis and treatment on asthma related services in medicaid youth with asthma.
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Impact of mental health diagnosis and treatment on asthma related services in medicaid youth with asthma.

机译：心理健康诊断和治疗对有药物的青年哮喘患者哮喘相关服务的影响。

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摘要

The most common chronic condition among children and adolescents in the United States is asthma. An association between asthma and mental health has been reported by a multitude of studies. However, characterizing, specifying and quantifying the relationships between mental health comorbidities with the delivery of asthma related services have not been accomplished. This study examines asthma related health services in youth with asthma, including assessment of specific factors which may impact asthma-related utilization. Specifically, this study investigates the impact of depression, anxiety and attention deficit hyperactivity disorder (ADHD) and the treatment of these conditions on asthma-related expenditures and health service use using a statewide sample of 8,241 youth with asthma between age 6 years and 16 years continuously enrolled in Florida Medicaid over 36 months from January 2002 through December 2004.;The current research methodology improves upon prior studies by using individual mental health diagnoses, a larger sample size, and longitudinal data. Four models are used to address the delivery of health services. The first model seeks to explain the effect of ADHD, anxiety, and depression on asthma related use and expenditures. The second model examines the length of mental health diagnosis on asthma-related use and expenditures. The third and fourth models assess the effect of mental health treatment on asthma-related use and expenditures.;General findings suggest asthma care for those with anxiety is costly with high utilization across all asthma-related outcomes, indicative of poor coordination. Comorbid depression was associated with greater inpatient service use, but generally less asthma medication fills, suggesting poor asthma adherence and coordination. Comorbid ADHD was associated with lower inpatient use and expenditures, and higher asthma related medication fills and medical claims suggesting better coordination and adherence to medication regimen and coordination of asthma management. Generally, mental health treatment tended to mediate the inpatient utilization for those with mental health conditions towards similar utilization to those without the condition. Depression treatment suggested better adherence, whereas anxiety treatment suggested more inpatient care. Better coordination of asthma management is indicated for those with comorbid anxiety and depression, as pediatricians tend to refer these patients to psychiatric services.
机译：在美国儿童和青少年中，最常见的慢性病是哮喘。大量研究报道了哮喘与心理健康之间的关联。然而，表征，指定和量化精神健康合并症与哮喘相关服务的提供之间的关系尚未完成。这项研究检查了哮喘青年中与哮喘有关的健康服务，包括评估可能影响哮喘相关利用的特定因素。具体而言，本研究使用了全州8241名6岁至16岁的青年哮喘患者，调查了抑郁症，焦虑症和注意缺陷多动障碍（ADHD）的影响以及这些疾病对哮喘相关支出和医疗服务使用的影响从2002年1月到2004年12月，在过去的36个月中，该研究机构连续登记在佛罗里达州的医疗补助计划中。四种模式用于解决卫生服务的提供。第一个模型试图解释多动症，焦虑和抑郁对哮喘相关使用和支出的影响。第二个模型检查了与哮喘有关的使用和支出方面的心理健康诊断时间。第三和第四种模型评估了心理健康治疗对哮喘相关使用和支出的影响。一般发现表明，对焦虑症患者的哮喘护理费用昂贵，并且在所有与哮喘相关的结局中利用率很高，表明协调性较差。合并抑郁症与住​​院服务的使用增加有关，但通常哮喘药物的使用较少，提示哮喘依从性和协调性较差。合并症多动症与较低的住院患者使用和支出，较高的哮喘相关用药量和医疗要求相关，提示更好的协调性和依从性以及对哮喘治疗的协调性。通常，精神卫生治疗倾向于将患有精神疾病的患者的住院利用调解为与没有疾病的患者类似的利用。抑郁治疗建议依从性更好，而焦虑治疗建议给予更多住院治疗。对于合并焦虑症和抑郁症的患者，哮喘治疗的协调性更好，因为儿科医生倾向于将这些患者转诊至精神科。

著录项

  • 作者

    Jamoom, Eric Wayne.;

  • 作者单位

    University of Florida.;

  • 授予单位 University of Florida.;
  • 学科 Health care management.;Medicine.;Mental health.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 163 p.
  • 总页数 163
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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