Epidemiology of psychiatric-related visits to emergency departments in a multicenter collaborative research pediatric network.
OBJECTIVE
Describe the epidemiology of pediatric psychiatric-related visits to emergency departments participating in the Pediatric Emergency Care Applied Research Network.


METHODS
Retrospective analysis of emergency department presentations for psychiatric-related visits (International Classification of Diseases, Ninth Revision, codes 290.0-314.90) for years 2003 to 2005 at 24 participating Pediatric Emergency Care Applied Research Network hospitals. All patients who had psychiatric-related emergency department visits aged 19 years or younger were eligible. Age, sex, race, ethnicity, insurance status, mode of arrival, length of stay, and disposition were described for psychiatric-related visits and compared with non-psychiatric-related visits.


RESULTS
Pediatric psychiatric-related visits accounted for 3.3% of all participating emergency department visits (84,973/2,580,299). Patients with psychiatric-related visits were older (mean +/- SD age, 12.7 +/- 3.9 years vs. 5.9 +/- 5.6 years, P < 0.001), had a higher rate ambulance arrival (19.4% vs 8.2%, P < 0.0001), had a longer median length of stay (3.2 vs 2.1 hours, P < 0.0001), and had a higher rate of admission (30.5% vs 11.2%, P < 0.0001) when compared with non-psychiatric-related patient presentations. Older age, female sex, white race, ambulance arrival, and governmental insurance were factors independently associated with admission or transfer from the emergency department for psychiatric-related visits in multivariate regression analyses.


CONCLUSIONS
Pediatric psychiatric-related visits require more prehospital and emergency department resources and have higher admission/transfer rates than non-psychiatric-related visits within a large national pediatric emergency network.
Mahajan
Prashant
P
Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan & Wayne State University, 3901 Beaubien, Detroit, MI 48201, USA. pmahajan@dmc.org
Alpern
Elizabeth R
ER
Grupp-Phelan
Jackie
J
Chamberlain
James
J
Dong
Lydia
L
Holubkov
Richard
R
Jacobs
Elizabeth
E
Stanley
Rachel
R
Tunik
Michael
M
Sonnett
Meridith
M
Miller
Steve
S
Foltin
George L
GL
D000293:Adolescent; D035843:Biomedical Research / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D019058:Community Networks / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009017:Morbidity / Q000639:trends; D010343:Patient Admission / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology