Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Nadler, Ariella; Avner, Deena; Khine, Hnin; Avner, Jeffrey R.; Fein, Daniel M.
• Is Part Of: Pediatric emergency care. Volume 37:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: pediatric mental health -- psychiatric emergencies -- length of stay; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000001473
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : 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.