PSYCHOPATHOLOGY AND HEALTH-CARE USE AMONG PRESCHOOL-CHILDREN - A RETROSPECTIVE ANALYSIS

Objective: To examine the relationship between psychopathology and hea lth care utilization beginning in the preschool (ages 2 to 5) years. M ethod: Five hundred ten preschool children were enrolled through 68 pr imary care physicians. The test battery used for diagnoses included th e Child Behavior Checklist, a developmental evaluation, the Rochester Adaptive Behavior Inventory, and a videotaped play session. Consensus DSM-III-R diagnoses were assigned using best-estimate procedures. Freq uency of primary care visits was established through 1-year retrospect ive record review; mothers estimated total visits and emergency depart ment (ED) use. Results: Logistic regression models showed that a DSM-I II-R diagnosis was related to increased ED use but not primary care or total visits. Greater functional impairment was associated with fewer primary care visits and more ED visits. Total, internalizing, and ext ernalizing behavior problem scores were associated with increased prim ary care and total visits; ED visits were associated with increased to tal and internalizing problems. Child's health status consistently cor related with utilization. Conclusion: There is a consistent relationsh ip between health care use and child psychopathology beginning in the preschool years.