Incidence of pediatric chronic tic disorders and feasibility of using the Massachusetts All-Payer Claims Database, 2012-2016.

Background: Nearly 1.5 million children in the United States have a chronic tic disorder, an under-recognized childhood-onset complex chronic condition characterized by involuntary movements and/or sounds, that is often comorbid with neuropsychiatric illness. This study sought to examine the feasibility of using the Massachusetts All-Payer Claims Database to identify incident cases of chronic tic disorders. Methods: In this retrospective analysis using the 2012-2016 Massachusetts All-Payer Claims Database, participants 4-18 years of age with health insurance for at least one year between 1/1/2013-12/31/2016 were included. Incident tic disorder diagnosis was defined as the first observed ICD-9/ICD-10 code for tic disorders with no diagnosis claim in the prior 12 months (e.g., Tourette Syndrome: 307.23, F95.2). Age at diagnostic encounter, sex, and insurance type were examined for those with an incident tic diagnosis. Results: Between 2012-2016, there were 1,638,691 unique claims for individuals aged 4-18 years. Of these, 1,258 unique claims had an incident tic disorder diagnosis. The mean age (± standard deviation) at diagnostic encounter was 9.7±3.5 years. Participants were predominantly male (74.5%) and had Medicaid coverage (64.8%). Conclusions: The Massachusetts All-Payer Claims Database is feasible to examine the incidence of chronic tic disorders in a pediatric population. Future studies will examine access to and quality of care in chronic tic disorders.