TY - JOUR
T1 - Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department
AU - Nadler, Ariella
AU - Avner, Deena
AU - Khine, Hnin
AU - Avner, Jeffrey R.
AU - Fein, Daniel M.
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period. Methods A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2). Visit information, including length of stay and demographic data, were compared between groups. Results There was a significant increase in the percentage of PED visits for EPE from period 1 to period 2 (1.1% vs 2.2% P < 0.0001). Overall, the median (interquartile range [IQR]) length of stay for children requiring an EPE increased significantly for all visits (5.3 [3.2-15.4] hours vs 17.0 [6.0-26.0] hours, P < 0.0001), including for patients who were admitted (17.8 [7.4-24.6] hours vs 27.0 [21.0-36.0] hours, P < 0.0001) and for those who were discharged (4.5 [2.8-7.7] hours vs 8 [5-20] hours, P < 0.0001). Conclusions Over a decade, the percentage of children with an EPE has doubled, with a significant increase in the amount of time spent in the PED. This highlights a continued surge in the utilization of PED resources for EPE.
AB - Objective The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period. Methods A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2). Visit information, including length of stay and demographic data, were compared between groups. Results There was a significant increase in the percentage of PED visits for EPE from period 1 to period 2 (1.1% vs 2.2% P < 0.0001). Overall, the median (interquartile range [IQR]) length of stay for children requiring an EPE increased significantly for all visits (5.3 [3.2-15.4] hours vs 17.0 [6.0-26.0] hours, P < 0.0001), including for patients who were admitted (17.8 [7.4-24.6] hours vs 27.0 [21.0-36.0] hours, P < 0.0001) and for those who were discharged (4.5 [2.8-7.7] hours vs 8 [5-20] hours, P < 0.0001). Conclusions Over a decade, the percentage of children with an EPE has doubled, with a significant increase in the amount of time spent in the PED. This highlights a continued surge in the utilization of PED resources for EPE.
KW - length of stay
KW - pediatric mental health
KW - psychiatric emergencies
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U2 - 10.1097/PEC.0000000000001473
DO - 10.1097/PEC.0000000000001473
M3 - Article
C2 - 29596285
AN - SCOPUS:85070549126
SN - 0749-5161
VL - 37
SP - 1
EP - 3
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 1
ER -