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Length of stay of pediatric mental health emergency department visits in the United States.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Case, Sarah D. Case, Brady G. Olfson, Mark Linakis, James G. Laska, Eugene M.
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Case SD ( Warren Alpert Medical School of Brown University, USA.)
Abstract	OBJECTIVE: To compare pediatric mental health emergency department visits to other pediatric emergency department visits, focusing on length of stay. METHOD: We analyzed data from the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of US emergency department visits from 2001 to 2008, for patients aged ≤18 years (n = 73,015). Visits with a principal diagnosis of a mental disorder (n = 1,476) were compared to visits (n = 71,539) with regard to patient and hospital characteristics, treatment, and length of stay. Predictors of prolonged mental health visits were identified. RESULTS: Mental health visits were more likely than other visits to arrive by ambulance (21.8% versus 6.3%, p < .001), to be triaged to rapid evaluation (27.9% versus 14.9%, p < .001), and to be admitted (16.4% versus 7.6%, p < .001) or transferred (15.7% versus 1.5%, p < .001). The median length of stay for mental health visits (169 minutes) significantly exceeded that of other visits (108 minutes). The odds of extended stay beyond 4 hours for mental health visits was almost twice that for other visits (adjusted odds ratio 1.9, 95% CI = 1.5-2.4) and was not explained by observed differences in evaluation, treatment, or disposition. Among mental health visits, advancing calendar year of study, intentional self-injury, age 6-13 years, Northeastern, Southern, and metropolitan hospital location, use of laboratory studies, and patient transfer all predicted extended stays. CONCLUSIONS: Compared with other pediatric emergency visits, mental health visits are longer, are more frequently triaged to urgent evaluation, and more likely to result in patient admission or transfer, thereby placing distinctive burdens on US emergency departments.
File Format	HTM / HTML
ISSN	08908567
e-ISSN	15275418
DOI	10.1016/j.jaac.2011.08.011
Journal	Journal of the American Academy of Child & Adolescent Psychiatry
Issue Number	11
Volume Number	50
Language	English
Publisher	Elsevier
Publisher Date	2011-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Psychiatry Discipline Pediatrics Emergency Services, Psychiatric Length Of Stay Mental Disorders Epidemiology Adolescent Child, Preschool Statistics & Numerical Data Health Surveys Infant Diagnosis Therapy Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Developmental and Educational Psychology Psychiatry and Mental Health

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