National trends in mental health-related emergency department visits by children and adults, 2009-2015
National trends in mental health-related emergency department visits by children and adults, 2009-2015
复制标题
DOI：
10.1016/j.ajem.2019.12.035
复制
发表时间：
2020-12-01
影响因子：
3.6
通讯作者：
Menchine, Michael
中科院分区：
文献类型：
--
作者：
Santillanes, Genevieve;Axeen, Sarah;Menchine, Michael
目的：检查与心理健康相关的急诊室（艾德）就诊的趋势、处置和住院时间（LOS）的变化，按年龄描述处置并估计专门用于心理健康相关就诊的艾德治疗时间的比例。方法：回顾性分析2009年至2015年全国医院门诊医疗访问调查中精神健康一级、二级或三级出院诊断的艾德遭遇。我们报告调查加权估计的数量和比例的艾德访问的心理健康和处置的年龄和调查年。我们估计了专门用于心理健康相关访问的艾德治疗小时的比例。我们使用多变量回归分析来分析心理健康和非心理健康相关就诊的处置和LOS趋势。结果：2015年，儿童患者和成人患者的心理健康相关艾德就诊增加了56.4%和40.8%，占15-64岁人群艾德就诊的10%以上，10-14岁人群占近9%。入院或转院的心理健康相关就诊处置从29.8%下降到20.4%（p <0.001）;入院或转院的预测中位艾德LOS从6.5小时增加到9.0小时，而出院的中位LOS稳定在4.4小时。在研究期间，心理健康相关的访问占5.0%（95%CI 4.6-5.3）的所有儿科和11.1%（95%CI 11.0-11.3）的成人艾德治疗hours.Conclusions：心理健康相关的访问占越来越多的比例艾德访问和相当大的比例的治疗时间。精神健康相关就诊比例的下降导致住院患者的处置和艾德LOS因入院和转院而增加。(C)2019爱思唯尔公司All rights reserved.
Objectives: Examine trends in mental health-related emergency department (ED) visits, changes in disposition and length of stay (LOS), describe disposition by age and estimate proportion of ED treatment hours dedicated to mental health-related visits.Methods: Retrospective analysis of ED encounters in the National Hospital Ambulatory Medical Care Visit Survey with a mental health primary, secondary or tertiary discharge diagnosis from 2009 to 2015. We report survey-weighted estimates of the number and proportion of ED visits that were mental health-related and disposition by age and survey year. We estimate the proportion of ED treatment hours dedicated to mental health-related visits. We analyze trends in disposition and LOS for mental health and non-mental health-related visits using multivariate regression analysis.Results: Mental health-related ED visits increased by 56.4% for pediatric patients and 40.8% for adults, accounting for over 10% of ED visits by 15-64 year-olds and nearly 9% by 10-14 year-olds in 2015. Mental health-related visit disposition of admission or transfer declined from 29.8% to 20.4% (p < .001); predicted median ED LOS for admissions or transfers increased from 6.5 to 9.0 hours while median LOS for discharges was stable at 4.4 hours. During the study period, mental health-related visits accounted for 5.0% (95% CI 4.6-5.3) of all pediatric and 11.1% (95% CI 11.0-11.3) of adult ED treatment hours.Conclusions: Mental health-related visits account for an increasing proportion of ED visits and a considerable proportion of treatment hours. A decreasing proportion of mental health-related visits resulted in inpatient disposition and ED LOS increased for admissions and transfers. (C) 2019 Elsevier Inc. All rights reserved.