Article Title

Health Care Service Utilization Among Anxious and Nonanxious Youth

Publication Date



anxiety, mental health, youth, quality of care


Background: Anxiety disorders are the most common mental health problem, impacting 15% to 20% of youth at any given time. Despite high prevalence, little is known about the type of health care services utilized by anxious youth, impeding public health efforts to improve access to and quality of care. To address this need, the current study will directly compare service utilization in a large sample of anxious and nonanxious youth patients enrolled within Mental Health Research Network (MHRN).

Methods: Preliminary analyses were conducted using a sample of 17,929 youths (ages 4 to 17 years) from Kaiser Permanente Northwest (KPNW). Anxiety diagnoses were derived from ICD-9 codes and service use from procedure codes during 2013–2014. Analyses were completed using a match-control design, in which anxious youth were matched with their nonanxious peers using sociodemographic indices.

Results: Results from the KPNW site showed that anxious youth were significantly more likely to receive care than nonanxious matched controls in pediatrics (odds ratio [OR]: 2.28; P < 0.001), family medicine (OR: 1.36; P < 0.001), emergency departments (OR: 2.23; P < 0.001), and urgent care (OR: 1.66; P < 0.001). Anxious youth also were more likely to receive services in specialty care settings such as outpatient mental health (OR: 17.34; P < 0.001), inpatient mental health (OR: 16.56; P < 0.001), neurology (OR: 3.71; P < 0.001) and cardiology (OR: 2.85; P < 0.001). Overall, anxious youths in this insured sample were high utilizers of services, including increased use of high-cost services.

Conclusion: Final analyses will integrate data from an additional three MHRN sites using innovative statistical methods designed to pool and analyze de-identified services data across multiple sites. The present study will be one of the first to examine health services use for a large and diverse sample of anxious youth across several different health care settings and systems. Findings from this study will provide unique and critical information about the availability and type of care currently utilized by anxious youth. Results may be useful in guiding efforts to most efficiently intervene with this widely prevalent and highly impairing condition.




June 29th, 2017


August 10th, 2017