Factors Associated With Child and Youth Mental Health Readmissions From a US National Database

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引用次数: 0

Abstract

Objective

To describe and identify factors associated with mental health (MH) readmission rates for youth ages 5 to 17 years discharged between January 2019 and November 2019.

Method

This retrospective, cross-sectional analysis using the 2019 Nationwide Readmissions Database identified hospitalizations for patients with a primary diagnosis of an MH condition using the Clinical Classification Software groupings, which are based on ICD-10-CM codes. Various patient characteristics including comorbidities were included in univariate and multivariate analysis to study their association with psychiatric readmission.

Results

A 30-day readmission rate of 7.8% was found for the overall sample with significantly higher rates for youth younger than age 15 years. MH comorbidity was a factor in readmission rates; having ≥3 primary MH conditions was associated with higher rates of readmission (adjusted odds ratio [aOR] = 1.20). Significantly higher rates of readmission were noted for several diagnostic groupings including schizophrenia spectrum and other psychotic disorders (aOR = 1.95); bipolar and related disorders (aOR = 1.42); other specified and unspecified mood disorders (aOR = 1.42); disruptive, impulse-control, and conduct disorders (aOR = 1.32); and neurodevelopmental disorders (aOR = 1.23). Having public insurance (aOR=1.28) and a longer length of stay (AOR = 1.71 for ≥15 days) were associated with significantly higher odds of an MH readmission.

Conclusion

A concerning number of children admitted for MH conditions in 2019 were readmitted within 30 days (7.8%). Younger children, children with specific MH diagnoses, children with public health insurance, and children with a long initial length of stay have higher odds for readmission and represent a target for prevention and intervention.

Plain language summary

Hospital readmissions for mental health may reflect healthcare quality. This study examined data from the National Readmission Database in patients 5 to 17 years old with a primary diagnosis of a mental health condition in order to identify factors associated with readmissions. Results showed that 7.8% of youth were readmitted to the hospital within 30 days. A higher number of co-occurring primary mental health conditions, certain diagnostic groups, those with longer initial lengths of stay, and public insurance were associated with higher odds of readmission These factors represent important targets for prevention and intervention.

Diversity & Inclusion Statement

We worked to ensure that the study questionnaires were prepared in an inclusive way. Diverse cell lines and/or genomic datasets were not available. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.

美国国家数据库中与儿童和青少年心理健康再入院相关的因素
方法这项回顾性横断面分析使用了2019年全国再入院数据库,使用基于ICD-10-CM代码的临床分类软件分组确定了主要诊断为精神疾病的住院患者。在单变量和多变量分析中纳入了包括合并症在内的各种患者特征,以研究它们与精神病再入院的关系。结果发现,总体样本的 30 天再入院率为 7.8%,15 岁以下青少年的再入院率明显更高。精神疾病合并症是影响再入院率的一个因素;合并≥3种主要精神疾病与较高的再入院率有关(调整赔率[aOR] = 1.20)。精神分裂症谱系和其他精神病性障碍(aOR = 1.95)、双相情感障碍和相关障碍(aOR = 1.42)、其他特定和未指定的情绪障碍(aOR = 1.42)、破坏性、冲动控制和行为障碍(aOR = 1.32)以及神经发育障碍(aOR = 1.23)等几种诊断分组的再入院率显著较高。拥有公共保险(aOR=1.28)和住院时间较长(≥15天的AOR=1.71)与精神疾病再入院的几率显著增加有关。年龄较小的儿童、有特殊精神疾病诊断的儿童、有公共医疗保险的儿童以及最初住院时间较长的儿童再次入院的几率较高,是预防和干预的目标。这项研究研究了全国再入院数据库中主要诊断为精神疾病的 5 至 17 岁患者的数据,以确定与再入院相关的因素。结果显示,7.8% 的青少年在 30 天内再次入院。这些因素是预防和干预的重要目标。我们努力确保以包容的方式准备研究问卷。没有提供多种细胞系和/或基因组数据集。本文的一位或多位作者自认为是一个或多个历史上在科学领域代表性不足的种族和/或民族群体的成员。本文的一位或多位作者自认为是一个或多个在科学界代表性不足的性和/或性别群体的成员。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAACAP open
JAACAP open Psychiatry and Mental Health
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