ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

Area of Science:

• Pediatric mental health services research
• Healthcare quality improvement
• Health services utilization

Background:

• A national quality measure assesses timely follow-up for pediatric mental illness hospitalizations.
• Understanding the link between follow-up adherence and subsequent acute care use is essential for improving care quality.

Purpose of the Study:

• To examine the relationship between adherence to a national quality measure for timely follow-up care and subsequent emergency department (ED) visits or hospitalizations for mental health conditions in pediatric patients.
• To identify factors associated with decreased adherence to follow-up care.

Main Methods:

• Analysis of the Truven MarketScan Medicaid Database (2015-2016) for pediatric hospitalizations (ages 6-17) with primary mental illness diagnoses.
• Cox proportional hazard models were used to assess the association between outpatient follow-up within 7 and 30 days and time to subsequent mental health-related ED visits or hospitalizations.

Main Results:

• 62.0% of hospitalizations had 7-day follow-up, and 82.3% had 30-day follow-up.
• 22.4% experienced subsequent acute care use within 30 days, and 54.8% within 6 months.
• Timely follow-up was associated with increased subsequent acute care use (HR 7-day: 1.20; 30-day: 1.31).

Conclusions:

• Despite over half receiving 7-day follow-up, variations in adherence highlight the need for care improvements.
• The increased hazard of subsequent acute care use underscores the complexity of pediatric mental illness treatment and potential intervention points during follow-up visits.