Follow-up After Pediatric Mental Health Emergency Visits.

Area of Science:

• Pediatric mental health
• Healthcare access
• Emergency medicine

Background:

• Pediatric mental health (MH) emergency department (ED) encounters are common.
• Effective follow-up care is crucial for preventing readmissions and improving outcomes.
• Understanding factors influencing follow-up is essential for optimizing care pathways.

Purpose of the Study:

• To investigate outpatient mental health (MH) follow-up patterns after pediatric MH ED discharge.
• To identify patient characteristics associated with follow-up care access.
• To evaluate the impact of timely follow-up on subsequent acute care encounters.

Main Methods:

• Retrospective study of 28,551 children (6-17 years) discharged from MH EDs (Jan 2018-June 2019).
• Data sourced from IBM Watson MarketScan Medicaid database.
• Logistic regression and Cox proportional hazard models analyzed follow-up and return encounter risks.

Main Results:

• Only 31.2% and 55.8% of children had outpatient MH visits within 7 and 30 days post-discharge, respectively.
• Children with ≥14 prior MH visits had significantly higher odds (9.53) of 30-day follow-up.
• Timely 30-day follow-up decreased short-term return risk by 26% but increased later return risk.

Conclusions:

• Access to outpatient mental health care within 7-30 days of ED discharge is insufficient.
• Children with no prior outpatient MH care face the greatest access barriers.
• Interventions should focus on facilitating follow-up within 5 days of MH ED discharge to improve outcomes.