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Pediatric mental health emergency department visits from 2017 to 2022: A multicenter study.
Hoffmann, Jennifer A; Carter, Camille P; Olsen, Cody S; Ashby, David; Bouvay, Kamali L; Duffy, Susan J; Chamberlain, James M; Chaudhary, Sofia S; Glomb, Nicolaus W; Grupp-Phelan, Jacqueline; Haasz, Maya; O'Donnell, Erin P; Saidinejad, Mohsen; Shihabuddin, Bashar S; Tzimenatos, Leah; Uspal, Neil G; Zorc, Joseph J; Cook, Lawrence J; Alpern, Elizabeth R.
Affiliation
  • Hoffmann JA; Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Carter CP; Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
  • Olsen CS; Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
  • Ashby D; Division of Emergency Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
  • Bouvay KL; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
  • Duffy SJ; Department of Emergency Medicine, Brown University, Hasbro Children's Hospital, Providence, Rhode Island, USA.
  • Chamberlain JM; Department of Pediatrics, Brown University, Hasbro Children's Hospital, Providence, Rhode Island, USA.
  • Chaudhary SS; Division of Emergency Medicine, Children's National Medical Center, Washington, DC, USA.
  • Glomb NW; Division of Emergency Medicine, Department of Pediatrics and Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
  • Grupp-Phelan J; Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Haasz M; Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.
  • O'Donnell EP; Department of Pediatrics, Section of Emergency Medicine, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.
  • Saidinejad M; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Shihabuddin BS; Department of Emergency Medicine, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, Harbor UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Tzimenatos L; Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Uspal NG; Department of Emergency Medicine, University of California, Davis, Sacramento, California, USA.
  • Zorc JJ; Division of Emergency Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.
  • Cook LJ; Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Alpern ER; Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Acad Emerg Med ; 31(8): 739-754, 2024 Aug.
Article in En | MEDLINE | ID: mdl-38563444
ABSTRACT

BACKGROUND:

The COVID-19 pandemic adversely affected children's mental health (MH) and changed patterns of MH emergency department (ED) utilization. Our objective was to assess how pediatric MH ED visits during the COVID-19 pandemic differed from expected prepandemic trends.

METHODS:

We retrospectively studied MH ED visits by children 5 to <18 years old at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. We described visit length by time period prepandemic (January 2017-February 2020), early pandemic (March 2020-December 2020), midpandemic (2021), and late pandemic (2022). We estimated expected visit rates from prepandemic data using multivariable Poisson regression models. We calculated rate ratios (RRs) of observed to expected visits per 30 days during each pandemic time period, overall and by sociodemographic and clinical characteristics.

RESULTS:

We identified 175,979 pediatric MH ED visits. Visit length exceeded 12 h for 7.3% prepandemic, 8.4% early pandemic, 15.0% midpandemic, and 19.2% late pandemic visits. During the early pandemic, observed visits per 30 days decreased relative to expected rates (RR 0.80, 95% confidence interval [CI] 0.78-0.84), were similar to expected rates during the midpandemic (RR 1.01, 95% CI 0.96-1.07), and then decreased below expected rates during the late pandemic (RR 0.92, 95% CI 0.86-0.98). During the late pandemic, visit rates were higher than expected for females (RR 1.10, 95% CI 1.02-1.20) and for bipolar disorders (RR 1.83, 95% CI 1.38-2.75), schizophrenia spectrum disorders (RR 1.55, 95% CI 1.10-2.59), and substance-related and addictive disorders (RR 1.50, 95% CI 1.18-2.05).

CONCLUSIONS:

During the late pandemic, pediatric MH ED visits decreased below expected rates; however, visits by females and for specific conditions remained elevated, indicating a need for increased attention to these groups. Prolonged ED visit lengths may reflect inadequate availability of MH services.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Emergency Service, Hospital / COVID-19 Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Acad Emerg Med Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Emergency Service, Hospital / COVID-19 Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Acad Emerg Med Year: 2024 Document type: Article