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Care of children with psychiatric disorders at community hospitals
1Division of Clinical and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland.
Insights
Most child psychiatric hospitalizations occur in general hospitals, yet care quality is under-researched. This 1977 study found children, especially younger ones, often lacked psychiatrist contact, raising concerns about care standards.
Area of Science:
- Child and Adolescent Psychiatry
- Healthcare Services Research
- Pediatric Hospital Medicine
Background:
- Short-term general hospitals manage most pediatric psychiatric hospitalizations.
- Limited research exists on the quality of psychiatric care for children in these settings.
- Understanding service utilization is crucial for improving pediatric mental healthcare.
Purpose of the Study:
- To compare patient characteristics and hospital service use for children and adults with psychiatric diagnoses in general hospitals.
- To identify disparities in psychiatric care access for pediatric patients.
- To evaluate the involvement of psychiatrists, particularly child psychiatrists, in pediatric inpatient psychiatric care.
Main Methods:
- Analysis of data from 380 short-term general hospitals in 1977.
- Inclusion of 100,000 patients with primary psychiatric diagnoses, including 7,000 children.
- Comparison of hospitalization lengths and psychiatrist consultation rates across age groups.
Main Results:
- Children constituted 7% of psychiatric hospitalizations, primarily adolescents aged 12-17.
- Hospitalization duration varied by age, with older children having the longest stays.
- Most children under 12 and one-third of older children did not see a psychiatrist; child psychiatrist involvement was minimal.
Conclusions:
- Significant gaps exist in psychiatric care for hospitalized children within general hospitals.
- The limited access to psychiatrists raises concerns about the quality of care provided.
- Increased involvement of child psychiatrists in general hospitals is recommended to enhance pediatric mental healthcare.
Abstract:
Short-term general hospitals account for most psychiatric hospitalizations of children, but relatively little research has examined the psychiatric care of children at these facilities. This study compared the characteristics of and use of hospital services by children and adults who received a primary psychiatric diagnosis at 380 short-term general hospitals in 1977. Of the 100,000 patients studied, 7,000, or 7 percent, were children, most between the ages of 12 and 17. Children 12 and older were hospitalized the longest, a mean of 15.6 days, followed by adults (12.7 days), children between six and 11 (10.7 days), and children five and younger (5.6 days). The great majority of children under age 12 and roughly one-third of children between ages 12 and 17 were not seen by a psychiatrist during their hospital stay. Very few were seen by child psychiatrists. The authors believe that child psychiatrists should be concerned about the effect their relative absence from general hospitals has on quality of care.