To estimate temporal trends in pediatric primary care visits that included mental health (MH) issues using all-payer data from Massachusetts.
Key Findings:
Rate of PCP visits with any MH diagnosis increased from 5.9 visits per 100 children in Q1 2014 to 9.7 visits per 100 children in Q1 2023.
The most significant increase was for anxiety-related visits, which rose from 1.7% to 6.1% of PCP visits.
ADHD remained the most common diagnosis at PCP visits, with a rise from 5.0% to 6.7%.
Interpretation:
The increase in PCP visits with MH issues may indicate a rise in pediatric MH needs and improved capacity for screening and addressing these needs in primary care.
Limitations:
Results are limited to Massachusetts and may not generalize to other regions.
Claims data may be incomplete for diagnoses as they are primarily for billing purposes.
The study does not explore heterogeneity by patient subgroup or practice type.
Conclusion:
The findings suggest a need for enhanced MH training and clinical service capacity in pediatric primary care, particularly for anxiety and ADHD.
Workflow inefficiency, staffing shortages, compensation, and EHR burden remained leading concerns among physicians considering reducing clinical work or leaving their organizations.
