Behavioral Emergency Response Team Alert Disparities in a Single-Site Pediatric Hospital

Area of Science:

• Pediatric hospital medicine
• Behavioral emergency response systems
• Health equity and disparities

Background:

• Behavioral Emergency Response Teams (BERT) manage psychiatric emergencies and conflicts.
• BERT alert utilization in pediatric inpatient settings is not well-documented.
• This study investigates racial disparities in BERT alert activation.

Purpose of the Study:

• To identify racial differences in BERT alert occurrences among pediatric inpatients.
• To analyze factors associated with BERT alert activation and physical restraint use.

Main Methods:

• Retrospective cross-sectional review of inpatient BERT alerts from 2018-2020.
• Logistic regression analysis examined the association between race and BERT alerts.
• Adjusted for age, gender, ethnicity, payor, and mental health diagnosis (MHD).

Main Results:

• Black patients had significantly higher odds of receiving BERT alerts (aOR 2.1).
• Admissions with private insurance had lower odds of BERT alerts (aOR 0.4).
• Mental health diagnoses (MHD) were strongly associated with higher BERT alert and physical restraint use.

Conclusions:

• Black race, government insurance, and MHD were disproportionately represented in BERT alerts.
• MHD and BERT alerts correlate with increased physical restraint utilization.
• Findings highlight potential racial and socioeconomic disparities in behavioral emergency response.