Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation).
Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA
Methods: The study used multiple years of data from the Medical Expenditure Panel Survey (MEPS) to estimate the association between parental depression and health utilization and expenditures for children age 2 through 17. Separate analyses were conducted for children by age category: 2 to 4, 5 to 10, and 11 to 17. In addition to socioeconomic variables and case-mix adjustment, the study used indicators for maternal depression, paternal depression, and timing of depressive symptoms to study relationships with children’s health expenditures. Annual expenditures for all health care services, ER visits, and office based visits were examined as outcomes using multivariate logistic and linear regression analysis. STATA’s survey commands were used to account for the complex sample design of the MEPS.
Results: Maternal depression was associated with increased odds of any annual health care expenditures and with increased odds of multiple office-based visits and any hospital ER visits, but only for children in age categories 5 to 10 and 11 to 17. Paternal depression was associated with increased odds of children’s expenditures for children ages 11 to 17. Maternal depressive symptoms that were present in the prior year but not concurrently were associated with the odds of any hospital ER visits, but not with the odds of any health expenditures or with the odds of two or more office-based visits. Across all models, none of the parental depression indicators was associated with the level of children’s health expenditures among children using services.
Conclusions: This study’s results offer insights into the association between parental depression and children’s health expenditures and utilization. Findings demonstrate that parental gender and timing of depressive symptoms are important dimensions in the association between parental depression and children’s utilization of health care services. Additional research is needed to further understand the underlying mechanisms through which this association operates and to assess the feasibility and benefits screening and treatment of parental depression on children’s health care expenditures and utilization.