Annual Report on Health Care for Children and Youth in the United States: National Estimates of Cost, Utilization and Expenditures for Children With Mental Health Conditions

Torio, Celeste M; Encinosa, William; Berdahl, Terceira A.; McCormick, Marie C.; Simpson, Lisa

doi:10.1016/j.acap.2014.07.007

Cited by 176 publications

(111 citation statements)

References 67 publications

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“…1 Between 2006 and 2011, pediatric hospitalizations for mental disorders among US children have increased by nearly 50%, with total expenditures of $11.6 billion. 2 During this time period, however, the percent change in pediatric hospitalizations varied by type of psychiatric disorder. Pediatric hospitalizations for mood disorders significantly rose, whereas the percent change in hospitalizations for other mental disorders was stable and those for alcohol-related conditions declined.…”

Section: What This Study Addsmentioning

confidence: 99%

“…Pediatric hospitalizations for mood disorders significantly rose, whereas the percent change in hospitalizations for other mental disorders was stable and those for alcohol-related conditions declined. 2 Earlier studies also suggest that cooccurring psychiatric disorders, either as a primary or secondary diagnosis, are an important driver of pediatric hospitalizations and costs. Children with common mental disorders, such as autism and attention-deficit/hyperactivity disorder (ADHD), have higher health care use than children without these conditions.…”

Section: What This Study Addsmentioning

confidence: 99%

“…The cumulative rise in hospitalizations with a psychiatric diagnosis may be overestimated because repeat users were not excluded and the risk for readmission for psychiatric patients may be greater. 2,26 Third,…”

Section: Figurementioning

confidence: 99%

“…1,2 The psychiatric disorder groups, corresponding lowest CCS levels, and ICD-9 CM diagnosis codes are summarized in Supplemental Table 3.…”

Section: Psychiatric Disorder Groupsmentioning

confidence: 99%

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Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals

Zima¹,

et al. 2016

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OBJECTIVE: To describe recent, 10-year trends in pediatric hospital resource use with and without a psychiatric diagnosis and examine how these trends vary by type of psychiatric and medical diagnosis cooccurrence. METHODS:A retrospective, longitudinal cohort analysis using hospital discharge data from 33 tertiary care US children's hospitals of patients ages 3 to 17 years from January 1, 2005 through December 31, 2014. The trends in hospital discharges, hospital days, and total aggregate costs for each psychiatric comorbid group were assessed by using multivariate generalized estimating equations. RESULTS:From 2005 to 2014, the cumulative percent growth in resource use was significantly (all P < .001) greater for children hospitalized with versus without a psychiatric diagnosis (hospitalizations: +137.7% vs +26.0%; hospital days: +92.9% vs 5.9%; and costs: +142.7% vs + 18.9%). During this time period, the most substantial growth was observed in children admitted with a medical condition who also had a cooccurring psychiatric diagnosis (hospitalizations: +160.5%; hospital days: +112.4%; costs: +156.2%). In 2014, these children accounted for 77.8% of all hospitalizations for children with a psychiatric diagnosis; their most common psychiatric diagnoses were developmental disorders (22.3%), attentiondeficit/hyperactivity disorder (18.1%), and anxiety disorders (14.2%). CONCLUSIONS:The 10-year rise in pediatric hospitalizations in US children's hospitals is 5 times greater for children with versus without a psychiatric diagnosis. Strategic planning to meet the rising demand for psychiatric care in tertiary care children's hospitals should place high priority on the needs of children with a primary medical condition and cooccurring psychiatric disorders.

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Section: What This Study Addsmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

“…1,2 The psychiatric disorder groups, corresponding lowest CCS levels, and ICD-9 CM diagnosis codes are summarized in Supplemental Table 3.…”

Section: Psychiatric Disorder Groupsmentioning

confidence: 99%

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Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals

Zima¹,

et al. 2016

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“…16 Moreover, children with chronic physical health conditions are at particularly high risk of mental health comorbidity, and the presence of concomitant mental health disorders results in worse clinical and quality of life outcomes and higher health care use. 17 With robust training in mental health evaluation and treatments, all trainees will be better prepared to collaborate in the development of comprehensive care plans that address both the physical and mental needs of their patients.…”

Section: Nihmentioning

confidence: 99%

Closing the Gap: Improving Access to Mental Health Care Through Enhanced Training in Residency

Raval

Doupnik

2017

Pediatrics

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Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

Arakelyan

Freyleue

Avula

et al. 2023

JAMA

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ImportanceApproximately 1 in 6 youth in the US have a mental health condition, and suicide is a leading cause of death among this population. Recent national statistics describing acute care hospitalizations for mental health conditions are lacking.ObjectivesTo describe national trends in pediatric mental health hospitalizations between 2009 and 2019, to compare utilization among mental health and non–mental health hospitalizations, and to characterize variation in utilization across hospitals.Design, Setting, and ParticipantsRetrospective analysis of the 2009, 2012, 2016, and 2019 Kids’ Inpatient Database, a nationally representative database of US acute care hospital discharges. Analysis included 4 767 840 weighted hospitalizations among children 3 to 17 years of age.ExposuresHospitalizations with primary mental health diagnoses were identified using the Child and Adolescent Mental Health Disorders Classification System, which classified mental health diagnoses into 30 mutually exclusive disorder types.Main Outcomes and MeasuresMeasures included number and proportion of hospitalizations with a primary mental health diagnosis and with attempted suicide, suicidal ideation, or self-injury; number and proportion of hospital days and interfacility transfers attributable to mental health hospitalizations; mean lengths of stay (days) and transfer rates among mental health and non–mental health hospitalizations; and variation in these measures across hospitals.ResultsOf 201 932 pediatric mental health hospitalizations in 2019, 123 342 (61.1% [95% CI, 60.3%-61.9%]) were in females, 100 038 (49.5% [95% CI, 48.3%-50.7%]) were in adolescents aged 15 to 17 years, and 103 456 (51.3% [95% CI, 48.6%-53.9%]) were covered by Medicaid. Between 2009 and 2019, the number of pediatric mental health hospitalizations increased by 25.8%, and these hospitalizations accounted for a significantly higher proportion of pediatric hospitalizations (11.5% [95% CI, 10.2%-12.8%] vs 19.8% [95% CI, 17.7%-21.9%]), hospital days (22.2% [95% CI, 19.1%-25.3%] vs 28.7% [95% CI, 24.4%-33.0%]), and interfacility transfers (36.9% [95% CI, 33.2%-40.5%] vs 49.3% [95% CI, 45.9%-52.7%]). The percentage of mental health hospitalizations with attempted suicide, suicidal ideation, or self-injury diagnoses increased significantly from 30.7% (95% CI, 28.6%-32.8%) in 2009 to 64.2% (95% CI, 62.3%-66.2%) in 2019. Length of stay and interfacility transfer rates varied significantly across hospitals. Across all years, mental health hospitalizations had significantly longer mean lengths of stay and higher transfer rates compared with non–mental health hospitalizations.Conclusions and RelevanceBetween 2009 and 2019, the number and proportion of pediatric acute care hospitalizations due to mental health diagnoses increased significantly. The majority of mental health hospitalizations in 2019 included a diagnosis of attempted suicide, suicidal ideation, or self-injury, underscoring the increasing importance of this concern.

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Annual Report on Health Care for Children and Youth in the United States: National Estimates of Cost, Utilization and Expenditures for Children With Mental Health Conditions

Cited by 176 publications

References 67 publications

Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals

Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals

Closing the Gap: Improving Access to Mental Health Care Through Enhanced Training in Residency

Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

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