Health care use by children diagnosed as having developmental delay

Abstract

Background: Although children with developmental delay are known to have increased health care use, it is unclear what proportion of that health care use is related to associated chronic health conditions.

Objectives: To assess the prevalence of isolated developmental delay and to determine the role of developmental delay in health care use controlling for chronic health conditions.

Design: Retrospective cohort study using Washington State Medicaid claims records from November 1, 1990, to December 31, 1997, an administrative data set that contains both International Classification of Diseases, Ninth Revision, Clinical Modification codes and billed services.

Patients and setting: Children born between November 1, 1990, and December 31, 1992, diagnosed as having developmental delay before the age of 5 years, enrolled in Medicaid within 1 month of birth, and continuously enrolled for at least 12 months. Four control subjects per case were matched on date of birth and duration of continuous enrollment in Medicaid.

Main outcome measures: Visits to physicians, emergency departments, other practitioners, or hospitals by year of life.

Results: One thousand two hundred forty-two children having developmental delay and 5370 children without developmental delay were included. One percent of those who met study criteria had developmental delay without chronic health conditions and 30% of the children with developmental delay had no associated chronic health conditions. Boys were 1.6 times as likely to have a diagnosis of developmental delay. Developmental delay was independently associated with increased health care use by all 4 measures used.

Conclusion: Developmental delay increases health care use apart from associated chronic health conditions.