Tea Rosic1, Laura Duncan1,2,3, Li Wang1,2,3, Mohamed Eltorki4, Michael Boyle1,2, Roberto Sassi1,2, Kathryn Bennett1,2,3, Lawna Brotherston5, Paulo Pires1, Olabode Akintan1, Ellen Lipman1,2. 1. Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. 2. Offord Centre for Child Studies, Hamilton, Ontario, Canada. 3. Department of Health Research Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario, Canada. 4. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. 5. Child and Youth Mental Health Program, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Abstract
OBJECTIVE: From 2007-2017, pediatric emergency department (ED) visits for mental health concerns increased by 66% in Canada, with repeat visits accounting for a significant proportion of all visits. Our objective was to examine patient and visit characteristics associated with repeat visits to a tertiary care pediatric ED for mental health concerns. METHOD: Data were obtained from the administrative records of McMaster Children's Hospital ED for mental health-related visits from February 2013-December 2017. Data on 9,018 ED visits made by 4,976 unique patients were included in this study. Logistic regression analysis was used to examine characteristics associated with repeat visit within six months of index presentation. RESULTS: 22% (n=1,088) of individuals returned to the ED for a mental health concern within six months following their index visit. A repeat visit within six months was associated with female sex (OR=1.19, p=0.019), age of 14-17 years (OR=1.42, p=0.016), receiving a risk assessment by the emergency psychiatry team (OR=1.63, p<0.001) and having an inpatient psychiatric admission (OR=1.67, p<0.001) at the index visit. Receiving anxiety-related discharge diagnoses at an index visit reduced the odds of a repeat visit within 6 months (OR=0.76, p=0.035), while receiving depression-related discharge diagnoses increased the odds of a repeat visit, but only for females (OR=1.3, p=0.011 vs. OR=0.93, p=0.589 for males). CONCLUSIONS: We found that approximately one in five patients presenting to the ED for a mental health concern have a repeat visit within six months, consistent with previous studies. This study provides support for previously identified risk factors for repeat visits and offers information on interactions between patient sex and diagnosis.
OBJECTIVE: From 2007-2017, pediatric emergency department (ED) visits for mental health concerns increased by 66% in Canada, with repeat visits accounting for a significant proportion of all visits. Our objective was to examine patient and visit characteristics associated with repeat visits to a tertiary care pediatric ED for mental health concerns. METHOD: Data were obtained from the administrative records of McMaster Children's Hospital ED for mental health-related visits from February 2013-December 2017. Data on 9,018 ED visits made by 4,976 unique patients were included in this study. Logistic regression analysis was used to examine characteristics associated with repeat visit within six months of index presentation. RESULTS: 22% (n=1,088) of individuals returned to the ED for a mental health concern within six months following their index visit. A repeat visit within six months was associated with female sex (OR=1.19, p=0.019), age of 14-17 years (OR=1.42, p=0.016), receiving a risk assessment by the emergency psychiatry team (OR=1.63, p<0.001) and having an inpatient psychiatric admission (OR=1.67, p<0.001) at the index visit. Receiving anxiety-related discharge diagnoses at an index visit reduced the odds of a repeat visit within 6 months (OR=0.76, p=0.035), while receiving depression-related discharge diagnoses increased the odds of a repeat visit, but only for females (OR=1.3, p=0.011 vs. OR=0.93, p=0.589 for males). CONCLUSIONS: We found that approximately one in five patients presenting to the ED for a mental health concern have a repeat visit within six months, consistent with previous studies. This study provides support for previously identified risk factors for repeat visits and offers information on interactions between patient sex and diagnosis.
Entities:
Keywords:
child and adolescent; emergency room; mental health; return visit
Authors: Amanda S Newton; Samina Ali; David W Johnson; Christina Haines; Rhonda J Rosychuk; Rachel A Keaschuk; Philip Jacobs; Mario Cappelli; Terry P Klassen Journal: Acad Emerg Med Date: 2010-02 Impact factor: 3.451
Authors: Amanda S Newton; Samina Ali; David W Johnson; Christina Haines; Rhonda J Rosychuk; Rachel A Keaschuk; Philip Jacobs; Terry P Klassen Journal: CJEM Date: 2009-09 Impact factor: 2.410