In:
Journal of Adolescence, Wiley, Vol. 72, No. 1 ( 2019-04), p. 132-140
Abstract:
We sought to understand the association between youthful self‐harm and subsequent chronic disease‐related healthcare utilization and whether self‐harm reflects unique vulnerability in comparison with severe psychiatric disorders. Methods We used a retrospective matched cohort design with statewide, all‐payer, individually linked emergency department (ED) data from California, USA. Risk of future ED visits for common chronic conditions in adolescence (headaches, asthma, epilepsy, diabetes, and gastrointestinal disorders, assessed using ICD‐9 diagnoses) were compared between three adolescent study groups presenting to an ED in 2010: self‐harm patients (n = 5,484), patients with psychiatric complaints but no self‐harm (n = 14,235), and patients with other complaints (n = 16,452). Cohort follow‐up ended on Sept. 30, 2015. Analyses were adjusted for patients' prior histories of ED utilization for chronic conditions as well as patient‐ and area‐level sociodemographic characteristics. Results Risk of subsequent ED visits was higher among self‐harm patients compared to non‐psychiatric control patients for subsequent epilepsy‐ (aRR = 1.77, 95% CI [1.42, 2.21]). Risk of subsequent ED visits was higher among psychiatric patients compared to non‐psychiatric control patients for subsequent headache‐ (aRR = 1.31, 95% CI [1.21, 1.42] ), and epilepsy‐related problems (aRR = 1.85, 95% CI [1.55, 2.21]). Self‐harm patients were at higher risk than psychiatric patients for subsequent gastrointestinal disorder (aRR = 1.76, 95% CI [1.03, 3.01] ). Conclusions Findings suggest that self‐harm behavior and psychiatric disorders are associated with increased ED utilization for subsequent chronic disease‐related ED utilization. Chronic disease among adolescent psychiatric patients should be attended to, potentially involving new models of clinical follow‐up care.
Type of Medium:
Online Resource
ISSN:
0140-1971
,
1095-9254
DOI:
10.1016/j.adolescence.2019.03.005
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
1469149-8
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