Admissions for Pediatric Somatic Symptom and Related Disorders: A National Database Study

Pediatric somatic symptom and related disorders (SSRDs) negatively impact patients' lives and can lead to hospitalization. No national U.S. studies have examined inpatient SSRD prevalence and health care utilization. We aimed to report demographic characteristics and health care utilization of patients admitted for pediatric SSRDs using the Pediatric Health Information System (PHIS) and identify characteristics associated with high utilization.

We included inpatient encounters from 2016 through 2023 for patients 5 to 21 years old with an admitting or primary SSRD diagnosis. We used descriptive statistics to summarize patient- and encounter-level variables and multivariable logistic regression to identify factors independently associated with high utilization (readmission or >75th percentile length of stay [LOS] or cost).

There were 6820 encounters and 6297 patients from 48 hospitals. Most patients were 12 to 18 years old (n = 4889, 78%), female (74%, n = 4666), and non-Hispanic white (55%, n = 3449). Median LOS was 2 days (IQR, 1-4), and median encounter cost was $7946 (IQR, 4737-13 701). Four hundred sixteen patients (7%) had multiple admissions. Carrying 7 or more diagnoses and Northeast hospitalization were associated with higher odds of prolonged LOS, high cost, and readmission. Odds of prolonged LOS alone were higher with commercial insurance (odds ratio [OR], 1.19 [95% CI, 1.03-1.36]) and comorbid anxiety (OR, 1.29 [95% CI, 1.10-1.51]). Hispanic patients had higher odds of high-cost admission (OR, 1.57 [95% CI, 1.24-1.99]) compared with non-Hispanic white patients.

An average of 853 admissions for SSRDs occur annually across 48 US tertiary care children's hospitals and affect a sociodemographically diverse population. Further investigation into drivers of disparate health care utilization is needed.