A diagnostic subgroup comparison of healthcare utilization patterns in individuals with eating disorders diagnosed in childhood and/or adolescence

Objective — This study examined a 2-year period after diagnosis of an eating disorder to compare healthcare utilization in diagnostic subgroups including: anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), and other specified eating disorders (Other).

Method — We conducted a retrospective study of children diagnosed with AN (n = 674), BN (n = 230), BED (n = 59), ARFID (n = 171), and Other (n = 315). We used a general population cohort for comparison, matched 5:1 to the diagnostic subgroups on sex and birth date. We then conducted a separate analysis using the ARFID subgroup as a reference group compared to the other subgroups. Outcomes were determined using data linkage with health administrative databases and included hospitalizations, emergency department, general practitioner, psychiatry, and pediatrician visits. Odds ratios (dichotomous outcomes) and rate ratios (continuous outcome) were calculated.

Results — Mental healthcare utilization was higher for all subgroups compared to the general population. When the subgroups were compared to the ARFID subgroup, those with ARFID appeared to have similar healthcare utilization to the other subgroups, except when compared to those with AN. The AN subgroup had higher odds of a mental health related hospitalization (OR 1.62, 95% CI 1.04–2.5) higher rates of mental health related pediatrician visits (RR 1.76, 95% CI 1.26–2.46) and psychiatry visits (RR 1.69, 95% CI 1.07–2.68).

Conclusions — Those with ARFID have similar utilization as other subtypes of eating disorders, except when compared to those with AN who have higher healthcare utilization.