Maternal psychotic disorders and pediatric health care utilization: Medicaid-insured families in Pennsylvania

More than two-thirds of women who meet the criteria for a psychiatric disorder are parents. While studies have found that women with serious mental illness typically utilize less preventive and prenatal health services, the existing research on the association between maternal mental health and pediatric health care use is limited and inconsistent. Regular physician visits are particularly important during infancy and early childhood development (ages 0-4), because this is a crucial developmental period when children have more recommended preventive care than in later childhood while at the same time, their exposure to intervention outside of their immediate family is limited.

Using the Andersen Behavioral Model of Health Services Use as a conceptual framework, a retrospective analysis of Medicaid data for the state of Pennsylvania from 1999 to 2003 compared age-cohorts of children of mothers with and without psychotic disorders. Multivariate regression analyses examined the extent to which mothers with and without a psychotic disorder differed with respect to preventive pediatric health care receipt, reliance on emergency care, and the predisposing, enabling and need factors associated with pediatric health care use. Preliminary results indicate that while there are some significant differences between mothers with and without a psychotic disorder, both groups could benefit from strategies to improve adherence with recommended pediatric preventive care. Targeted prevention and intervention efforts may have the potential to enhance the health and well-being of many vulnerable families.