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Factors Associated With Prolonged Mental Health Admissions at US Children's Hospitals

Adrienne G DePorre1,2, Matt Hall1,2,3, Alec M Bernstein4,2

  • 1Divisions of Hospital Medicine.

Hospital Pediatrics
|April 8, 2024
PubMed

Insights

Prolonged mental health (MH) hospitalizations in children are linked to specific diagnoses and patient complexities. Addressing these factors can improve health equity and reduce lengthy stays.

Area of Science:

  • Pediatric Health Services Research
  • Child and Adolescent Psychiatry
  • Health Equity Studies

Background:

  • Mental health (MH) hospitalizations in medical settings often involve longer lengths of stay (LOS) than non-MH admissions.
  • Factors contributing to prolonged MH hospitalizations and associated costs in children remain unclear.
  • Understanding these factors is crucial for optimizing care and resource allocation.

Purpose of the Study:

  • To identify patient clinical and demographic factors associated with prolonged MH hospitalizations in children.
  • To examine variations in MH LOS across children's hospitals in the United States.
  • To inform targeted interventions for improving MH care delivery.

Main Methods:

  • Analysis of 42,654 primary MH hospitalizations for children aged 5-20 years (2021-2022).
  • Data sourced from the Pediatric Health Information System database across 46 children's hospitals.
  • Generalized estimating equations used to assess associations with prolonged hospitalization (>14 days).

Main Results:

  • The majority of hospitalizations were among adolescents (14-18 years, 62.4%), females (68.5%), and non-Hispanic white children (53.8%).
  • Suicide/self-injury (37.4%), depressive disorders (16.6%), and eating disorders (10.9%) were common primary MH diagnoses.
  • Prolonged hospitalizations (>14 days) affected 5.1% of patients, associated with race/ethnicity, MH diagnosis category, and medical/MH complexity.

Conclusions:

  • Specific diagnoses and clinical factors are key indicators for prolonged MH hospitalizations.
  • Targeted interventions, including enhanced behavioral and inpatient MH resources and discharge planning, are recommended.
  • Increased investment in community and inpatient MH supports can advance health equity and reduce prolonged hospitalizations.
Abstract

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