Demographic predictors of emergency service utilization patterns in youth at risk of suicide

Abstract

ObjectiveTo explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality (i.e., ideation or behaviors).MethodsElectronic health records were extracted from 2017 to 2021 for 3094 8–22 year‐old patients with a history of suicidality at an urban academic medical center ED in the Mid‐Atlantic. Logistic regression analyses were used to assess for demographic predictors of ED utilization frequency, timing of subsequent visits, and reasons for subsequent visits over a 24‐month follow‐up period.ResultsBlack race (OR = 1.45, 95% CI = 1.11–1.92), Female sex (OR = 1.59, 95% CI = 1.26–2.03), and having Medicaid insurance (OR = 1.71, 95% CI = 1.37–2.14) were associated with increased utilization, while being under 18 was associated with lower utilization (<12: OR = 0.38, 95% CI = 0.26–0.56; 12–18: OR = 0.47, 95% CI = 0.35–0.63). These demographics were also associated with ED readmission within 90 days, while being under 18 was associated with a lower odds of readmission.ConclusionsAmong patients with a history of suicidality, those who identify as Black, young adults, patients with Medicaid, and female patients were more likely to be frequent utilizers of the ED within the 2 years following their initial visit. This pattern may suggest inadequate health care access for these groups, and a need to develop better care coordination with an intersectional focus to facilitate utilization of other health services.