title: Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.
abstract: OBJECTIVE
  To examine national trends in hospital utilization, costs, and expenditures for children with mental health conditions.
  
  
  METHODS
  The analyses of children aged 1 to 17 are based on AHRQ's 2006 and 2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) databases, and on AHRQ's pooled 2006 to 2011 Medical Expenditure Panel Survey (MEPS). All estimates are nationally representative, and standard errors account for the complex survey designs.
  
  
  RESULTS
  Although overall all-cause children's hospitalizations did not increase between 2006 and 2011, hospitalizations for all listed mental health conditions increased by nearly 50% among children aged 10 to 14 years, and by 21% for emergency department (ED) visits. Behavioral disorders experienced a shift in underlying patterns between 2006 and 2011: inpatient stays for alcohol-related disorders declined by 44%, but ED visits increased by 34% for substance-related disorders and by 71% for impulse control disorders. Inpatient visits for suicide, suicidal ideation, and self-injury increased by 104% for children ages 1 to 17 years, and by 151% for children ages 10 to 14 years during this period. A total of $11.6 billion was spent on hospital visits for mental health during this period. Medicaid covered half of the inpatient visits, but with 50% to 30% longer length of stays in 2006 and 2011, respectively, than private payers. Medicaid's overall share of the ED visits increased from 45% in 2006 to 53% in 2011.
  
  
  CONCLUSIONS
  These alarming trends highlight the renewed need for research on mental health care for children. This study also provides a baseline for evaluating the impact of the Affordable Care Act and the mental health parity legislation on mental health utilization and expenditures for children.
authors.affiliation: Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, Md. Electronic address: celeste.torio@ahrq.hhs.gov.
authors.forename: Celeste Marie
authors.initials: CM
authors.lastname: Torio
authors.affiliation: Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, Md.
authors.forename: William
authors.initials: W
authors.lastname: Encinosa
authors.affiliation: Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, Md.
authors.forename: Terceira
authors.initials: T
authors.lastname: Berdahl
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Mass.
authors.forename: Marie C
authors.initials: MC
authors.lastname: McCormick
authors.affiliation: Academy Health, Washington, DC.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Simpson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008484:Medicaid; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D016728:Self-Injurious Behavior / Q000191:economics / Q000628:therapy; D019966:Substance-Related Disorders / Q000191:economics / Q000628:therapy; D014481:United States
keywords: children; health care utilization; mental health; national estimates; trends in hospitalization