Related Experiment Video
Updated: Aug 18, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Children With Medical Complexity and Mental and Behavioral Disorders in the Emergency Department
Sriram Ramgopal1, Denise M Goodman2, Kristin Kan3,4
1Divisions of Emergency Medicine.
Insights
Children with chronic complex conditions and mental or behavioral health disorders presenting to the emergency department (ED) require higher admission or transfer rates. This highlights a significant need for integrated care pathways for these vulnerable pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Child Health Services Research
- Healthcare Disparities
Background:
- Children with chronic complex conditions (CCC) and mental or behavioral health (MBH) disorders represent a growing population within emergency departments (EDs).
- Understanding the overlap and healthcare utilization patterns of these dual-diagnosis pediatric patients is crucial for effective resource allocation and care planning.
Purpose of the Study:
- To assess the prevalence of co-occurring chronic complex conditions (CCC) and mental or behavioral health (MBH) disorders in children presenting to the emergency department (ED).
- To determine the admission and/or transfer rates for pediatric patients with CCC and/or MBH disorders compared to those without these conditions.
Main Methods:
- A cross-sectional analysis was conducted using two large datasets: the Pediatric Health Information System (PHIS) and the Illinois COMPdata statewide sample.
- Pediatric ED encounters for patients aged 2 to 21 years were analyzed to compare admission and/or transfer rates between subgroups with CCC, MBH, or both.
- The study also investigated whether a primary MBH diagnosis influenced admission or transfer decisions in patients with both CCC and MBH.
Main Results:
- In the PHIS dataset (over 11.8 million encounters), 0.7% of patients had both MBH and CCC. These patients showed significantly higher admission/transfer rates (86.5%) compared to those with MBH alone (57.7%) or CCC alone (52.0%).
- The COMPdata set (over 5.3 million patients) showed similar trends, with 0.2% having both MBH and CCC, and higher admission/transfer rates (61.8%) compared to MBH alone (42.8%) or CCC alone (27.3%).
- Across both datasets, patients with both CCC and MBH had increased odds of admission or transfer when their primary diagnosis was MBH-related.
Conclusions:
- Children with chronic complex conditions and co-occurring mental or behavioral health disorders constitute a small but high-need subgroup within emergency departments.
- These patients demonstrate a significantly higher requirement for admission or transfer, underscoring the need for specialized care coordination and intervention strategies.
Background:
To assess the overlap and admission or transfer rate of children with chronic complex conditions (CCC) and with mental or behavioral health (MBH) disorders among children presenting to the emergency department (ED).
Methods:
We performed a cross-sectional analysis from 2 data sources: hospitals in the Pediatric Health Information System (PHIS) and from a statewide sample (Illinois COMPdata). We included ED encounters 2 to 21 years and compared differences in admission and/or transfer between subgroups. Among patients with both a CCC and MBH, we evaluated if a primary MBH diagnosis was associated with admission or transfer.
Results:
There were 11 880 930 encounters in the PHIS dataset; 0.7% had an MBH and CCC, 2.2% had an MBH, and 8.0% had a CCC. Patients with an MBH and CCC had a greater need for admission or transfer (86.5%) compared with patients with an MBH alone (57.7%) or CCC alone (52.0%). Among 5 362 701 patients in the COMPdata set, 0.2% had an MBH and CCC, 2.1% had an MBH, and 3.2% had a CCC, with similar admission or transfer needs between groups (61.8% admission or transfer with CCC and MBH; 42.8% MBH alone, and 27.3% with CCC alone). Within both datasets, patients with both a MBH and CCC had a higher odds of admission or transfer when their primary diagnosis was an MBH disorder.
Conclusions:
While accounting for a small proportion of ED patients, CCC with concomitant MBH have a higher need for admission or transfer relative to other patients.
More Related Videos
Related Concept Videos
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:28Conduct Disorder
01:30Methods of Documentation VII: EMR