title: Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals.
abstract: To describe recent, 10-year trends in pediatric hospital resource use with and without a psychiatric diagnosis and examine how these trends vary by type of psychiatric and medical diagnosis cooccurrence.
  
  
  
  A retrospective, longitudinal cohort analysis using hospital discharge data from 33 tertiary care US children's hospitals of patients ages 3 to 17 years from January 1, 2005 through December 31, 2014. The trends in hospital discharges, hospital days, and total aggregate costs for each psychiatric comorbid group were assessed by using multivariate generalized estimating equations.
  
  
  
  From 2005 to 2014, the cumulative percent growth in resource use was significantly (all P < .001) greater for children hospitalized with versus without a psychiatric diagnosis (hospitalizations: +137.7% vs +26.0%; hospital days: +92.9% vs 5.9%; and costs: +142.7% vs + 18.9%). During this time period, the most substantial growth was observed in children admitted with a medical condition who also had a cooccurring psychiatric diagnosis (hospitalizations: +160.5%; hospital days: +112.4%; costs: +156.2%). In 2014, these children accounted for 77.8% of all hospitalizations for children with a psychiatric diagnosis; their most common psychiatric diagnoses were developmental disorders (22.3%), attention-deficit/hyperactivity disorder (18.1%), and anxiety disorders (14.2%).
  
  
  
  The 10-year rise in pediatric hospitalizations in US children's hospitals is 5 times greater for children with versus without a psychiatric diagnosis. Strategic planning to meet the rising demand for psychiatric care in tertiary care children's hospitals should place high priority on the needs of children with a primary medical condition and cooccurring psychiatric disorders.
authors.affiliation: Departments of Psychiatry and Biobehavioral Science, UCLA Semel Institute for Neuroscience and Human Behavior, and bzima@mednet.ucla.edu.
authors.forename: Bonnie T
authors.initials: BT
authors.lastname: Zima
authors.affiliation: Children's Hospital Association, Overland Park, Kansas.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rodean
authors.affiliation: Children's Hospital Association, Overland Park, Kansas.
authors.forename: Matt
authors.initials: M
authors.lastname: Hall
authors.affiliation: Department of Pediatrics, UCSF School of Medicine, University of California, San Francisco, San Francisco, California; and.
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Bardach
authors.affiliation: General Pediatrics, UCLA Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
authors.forename: Tumaini R
authors.initials: TR
authors.lastname: Coker
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Berry
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics* / Q000639:trends; D006776:Hospitals, Pediatric / Q000191:economics* / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D012189:Retrospective Studies; D014481:United States