title: Toward Effective Utilization of the Pediatric Emergency Department: The Case of ADHD.
abstract: This project's purpose was to characterize attention-deficit/hyperactivity disorder (ADHD)-related emergency department (ED) visits compared with other psychiatric visits made by children with Medicaid and to determine whether any visits were avoidable. Medicaid claims of children who visited the ED for mental health services were analyzed. Logistic regression was used to examine whether demographic, ED-, and system-level variables increased the odds of an ED visit for children with Medicaid, comparing those with ADHD to other psychiatric diagnoses. Children who were African American, arrived during the daytime, and lived in counties with mental health professional shortages had greater odds of an ED visit for ADHD compared to other psychiatric visits. Approximately 24% of all ED visits were for ADHD and about 30% of these visits may have been avoidable. ADHD-related ED visits comprise a sizeable proportion of all ED visits. Some visits appeared to be emergent but possibly treatable in primary care.
authors.affiliation: a Department of Psychiatry , University of Florida-Jacksonville , Jacksonville , Florida , USA.|b Center for Health Equity & Quality Research, University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Lynch
authors.affiliation: b Center for Health Equity & Quality Research, University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Bautista
authors.affiliation: b Center for Health Equity & Quality Research, University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Freer
authors.affiliation: c Department of Emergency Medicine , University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Kalynych
authors.affiliation: a Department of Psychiatry , University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Cuffe
authors.affiliation: c Department of Emergency Medicine , University of Florida-Jacksonville , Jacksonville , Florida , USA.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Hendry
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D001523:Mental Disorders / Q000628:therapy; D010372:Pediatrics; D012189:Retrospective Studies; D014481:United States
keywords: Children; attention-deficit/hyperactivity disorder; emergency department; mental health