Behavioral Health Diagnoses Among Children and Adolescents Hospitalized in the United States: Observations and Implications.
Psychiatr Serv
; 69(8): 910-918, 2018 08 01.
Article
em En
| MEDLINE
| ID: mdl-29852825
ABSTRACT
OBJECTIVE:
The study described rates and characteristics of U.S. children hospitalized with a behavioral (mental or substance use) disorder.METHODS:
This cross-sectional analysis of data from the 2012 Kids' Inpatient Database included 483,281 hospitalizations in general and children's hospitals of persons under age 21 with a primary or secondary behavioral diagnosis.RESULTS:
The admission rate with any behavioral diagnosis was 5.5 per 1,000 children in the U.S. population, with 2.9 having a primary behavioral diagnosis. Common primary diagnoses included depression (34%), other mood (31%), psychotic (9%), and substance use (7%) disorders. The most common behavioral diagnoses secondary to a primary diagnosis that is not behavioral were depression (26%), attention-deficit disorder (26%), and substance use disorders (22%). Suicide or self-harm was rarely the primary diagnosis (.1%) but complicated 12% of admissions with a primary behavioral diagnosis. Variations in admissions (per 1,000 children in the U.S. population) with a primary behavioral diagnosis were noted by race-ethnicity (blacks, 3.2; whites, 2.9; and Hispanics, 1.4), insurance (public, 2.9; private, 2.0), and geographic region. Fifty-nine of every 1,000 peripartum admissions in the 12-20 age group had a secondary behavioral diagnosis. Patients with behavioral comorbidities were more likely to be transferred to another facility (8.0% versus 2.2%, p<.001). Behavioral disorders comorbid to nonbehavioral disorders increased length of stay (4.3 versus 3.3 days, p<.001) and costs ($12,742 versus $9,929, p<.001).CONCLUSIONS:
Nearly 500,000 pediatric admissions in 2012 included behavioral disorders. Comorbidities were associated with longer stays and an estimated $1.36 billion additional annual costs, which were disproportionately borne by public insurance.Palavras-chave
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
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Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Hospitalização
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Hospitais Gerais
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Hospitais Pediátricos
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Transtornos Mentais
Tipo de estudo:
Diagnostic_studies
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Health_economic_evaluation
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Newborn
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Psychiatr Serv
Assunto da revista:
PSIQUIATRIA
Ano de publicação:
2018
Tipo de documento:
Article