Introduction to Special Section on the Cost-Effectiveness and Economic Impact of Pediatric Psychology Interventions

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

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.

Pediatric medical psychology

Paediatric medical psychology is a specialised field within clinical health psychology focussed on the behavioural, developmental, and psychological needs of children, adolescents, and families in healthcare contexts. Paediatric medical psychologists address a myriad of problems by employing evidence-based evaluations and interventions in order to support the well-being of paediatric patients and their families. In this paper, we provide an overview of paediatric medical psychology including the education and training required to be a paediatric psychologist followed by common problems addressed by paediatric psychology, the settings paediatric psychologists work in, and the services they provide. Discussion concludes with future application of integrating paediatric psychology throughout the continuum of care to optimise adjustment and health of paediatric patients.