Psychiatric Boarding Hospitalizations for Children With Autism in a Children's Hospital System

Area of Science:

• Pediatric Psychiatry
• Autism Spectrum Disorder Research
• Healthcare Management

Background:

• Children with autism spectrum disorder (ASD) face higher hospitalization rates for psychiatric conditions.
• These children are at increased risk for agitation and physical restraint during hospital stays.
• Resource allocation in pediatric psychiatric care may impact patient and staff safety.

Purpose of the Study:

• To compare psychiatric boarding hospitalization outcomes for children with ASD.
• To evaluate differences between a main campus with enhanced resources and community campuses with limited resources.
• To assess the impact of resource availability on staff injuries and physical restraint use.

Main Methods:

• Retrospective cohort study of children with ASD hospitalized for psychiatric boarding.
• Data collected from October 2020 to September 2024 across a children's hospital system.
• Verification of ASD diagnosis and medical clearance through psychology evaluations.

Main Results:

• 174 children with ASD accounted for 347 hospitalizations; 77% occurred at the main campus.
• Median age was 13 years, 72% were male; median length of stay was 6 days.
• Staff injury incidence was significantly lower at the main campus (22% vs. 42%, P=.02), but physical restraint incidence was similar.

Conclusions:

• Enhanced resources at the main campus correlated with reduced staff injuries during psychiatric boarding for children with ASD.
• Resource availability did not significantly impact physical restraint use.
• Further research is needed on ASD care models and safety in pediatric inpatient settings.