TABLE 1

Descriptive Characteristics of the Study Sample

Children With Mental Health Conditionsa (N = 69 233)Subset With High Mental Health Expendituresb (N = 4292)
Sex, % female (N)45.2 (31 285)35.5 (1524)
Age at baseline (2008), % (N)
 3–7 y21.1 (14 577)15.9 (682)
 8–11 y24.7 (17 065)29.8 (1278)
 12–15 y31.7 (21 941)33.4 (1432)
 16–18 y22.6 (15 650)21.0 (900)
Insurance product, % (N)
 Health maintenance organization7.1 (4901)6.1 (262)
 Point of service61.1 (42 271)62.5 (2682)
 Preferred provider organization25.0 (17 329)25.7 (1102)
 Other (eg, indemnity, exclusive provider organization)6.8 (4732)5.7 (246)
Consumer-directed health plan, % (N)8.6 (5949)7.8 (336)
Mental health diagnoses, % (N)c
 Schizophrenia0.1 (91)Blindedd
 Psychosis0.6 (412)3.2 (136)
 Bipolar disorder2.7 (1852)16.9 (732)
 Depression8.8 (6098)20.2 (865)
 Major depressive disorder5.1 (3539)15.1 (648)
 Anxiety or posttraumatic stress disorder12.4 (8556)29.2 (1253)
 Phobia or obsessive-compulsive disorder2.5 (1726)9.3 (397)
 Attention-deficit/hyperactivity disorder28.8 (19 928)65.5 (2813)
 Any conduct disorder3.8 (2656)12.1 (519)
 Personality disorder0.4 (270)2.0 (86)
 Adjustment disorder14.3 (9882)19.9 (856)
 Substance use disorder1.5 (1010)4.6 (196)
Health service use and spending preparity (2008–2009)
 Any mental health outpatient or inpatient service use, %58.3 (40 386)96.9 (4161)
 Average annual total mental health spending, $8245453
 Average annual OOP mental health spending, $3271603
 Average annual OOP share of total mental health spending0.430.33
 Average annual No. mental health outpatient visits2.812.4
 Average annual No. mental health inpatient days0.11.0
 Average annual psychotropic medication spending, $2982335
 Average annual non–mental health spending, $25135096
  • a Children with mental health conditions identified by the presence of ≥2 outpatient or inpatient claims with any mental health diagnosis occurring on unique dates.

  • b High spenders were the subset of children with mental health conditions who met or exceeded the 85th percentile in total mental health spending summed over 2008 and 2009 (pre-MHPAEA years) and in total mental health spending summed over 2011 and 2012 (post-MHPAEA years).

  • c Child is identified as having a specific condition if the child has ≥2 claims with ICD-9-CM diagnosis codes for the same condition. Categories are nonexclusive, so children may be classified as having >1 condition.

  • d Cell sizes with <50 children represented are blinded.