Infectious Disease

The length of stay for ED visits to mental health children has increased significantly

April 08, 2021

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According to the study results published in Pediatrics, the rate of extended length of stay on ED visits in children increased significantly between 2005 and 2015 compared to ED visits related to non-mental health.

“When we look at ED length of stay as an indicator of quality and access, it is important to understand not only how we are doing at the national level, but also how we are evolving over time.” Katherine A. Nash, MD, of the National Clinician Scholars Program at Yale University School of Medicine, said Healio Psychiatry. “We have found this problem to get worse as more and more children spend hours and days in the emergency room each year, which is a delay in the care they need.”

Reference: Nash KA et al. Pediatr. 2021; doi: 10.1542 / peds.2020-030692.

Nash and colleagues wanted to compare trends in length of stay for pediatric mental health visits to non-mental ED visits, as well as assess the characteristics of patients associated with longer length of stay for ED mental health visits. They used the National Hospital Ambulatory Medical Care Survey (2005-2015) to conduct an observational analysis of ED visits in children ages 6-17. In particular, they used descriptive statistics and survey-weighted logistic regression to assess trends in extended length of stay rates and to determine whether demographic and clinical traits such as race and ethnicity, type of payer, and the presence of a concurrent diagnosis of physical health affected the extended length of stay remain influenced by.

The results showed that from 2005 to 2006 and 2014 to 2015, the average annual rate of ED dwell time greater than 6 hours for mental health visits increased from 16.3% to 24.6% and from 5.3%. increased to 12.7% for a length of stay of more than 12 years hours; The length of stay, however, was stable for non-mental health visits. Hispanic ethnicity was associated with an almost three times increased risk for stays longer than 12 hours (OR = 2.74; 95% CI, 1.6904.44) for mental health visits, but the payer type seemed to to be associated with a difference in length of stay.

“For children with mental health problems, every hour they spend in the emergency room is likely to delay necessary mental and behavioral health care,” said Nash. “More and more children are suffering from these delays, and this problem will only get worse after COVID-19 as more children come to the emergency room for psychiatric care.”

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