Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US
Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US
复制标题
DOI：
10.1542/peds.2018-2192
复制
发表时间：
2019-04-01
期刊：
影响因子：
8
通讯作者：
Riley, Anne
中科院分区：
文献类型：
--
作者：
Kalb, Luther G.;Stapp, Emma K.;Riley, Anne
在2011年至2015年期间，美国6至24岁的青少年精神科急诊科就诊人数有所增加。背景：以精神病学为目的访问急诊科（ED）是慢性和急性未满足的精神卫生需求的一个指标。在目前的研究中，我们调查了全国范围内6至24岁的个体是否在增加精神科急诊科就诊。方法：急诊科数据来自2011-2015年全国医院门诊医疗调查，这是一项全美急诊科就诊调查。使用《国际疾病分类》第九版和就诊原因代码对精神科急诊科就诊进行识别。采用调查加权逻辑回归分析来检查精神科急诊科就诊的趋势及其相关性。来自美国人口普查局的数据被用来检查人口比率。结果：2011年至2015年期间，美国每1000名青少年精神科急诊科就诊人数总体增加了28%（从31.3次增加到40.2次）。每1000名美国年轻人中，青少年（54%）、非裔美国人（53%）和西班牙裔患者（91%）的精神科急诊科就诊人数增幅最大。在青少年中观察到与自杀相关的就诊大幅增加（2.5倍）（每1000名美国青少年4.6-11.7次就诊）。虽然精神科急诊科的就诊时间很长（51%为3小时），但很少（16%）患者在就诊期间得到精神卫生专业人员的诊治。结论：在美国，青少年因精神病学目的到急诊科就诊的人数正在上升。急诊科需要精神病学专业知识和有效的心理健康治疗方案，特别是那些用于解决青少年中不断上升的自杀流行病的方案。
Between 2011 and 2015, there was an increase in psychiatric ED visits among youth 6 to 24 years of age in the United States.BACKGROUND: Visits to the emergency department (ED) for psychiatric purposes are an indicator of chronic and acute unmet mental health needs. In the current study, we examined if psychiatric ED visits among individuals 6 to 24 years of age are increasing nationwide. METHODS: ED data came from the 2011-2015 National Hospital Ambulatory Medical Care Survey, a national survey of ED visits across the United States. Psychiatric ED visits were identified by using the International Classification of Diseases, Ninth Revision and reason-for-visit codes. Survey-weighted logistic regression analyses were employed to examine trends in as well as correlates of psychiatric ED visits. Data from the US Census Bureau were used to examine population rates. RESULTS: Between 2011 and 2015, there was a 28% overall increase (from 31.3 to 40.2) in psychiatric ED visits per 1000 youth in the United States. The largest increases in psychiatric ED visits per 1000 US youth were observed among adolescents (54%) and African American (53%) and Hispanic patients (91%). A large increase in suicide-related visits (by 2.5-fold) was observed among adolescents (4.6-11.7 visits per 1000 US youth). Although psychiatric ED visits were long (51% were >= 3 hours in length), few (16%) patients were seen by a mental health professional during their visit. CONCLUSIONS: Visits to the ED for psychiatric purposes among youth are rising across the United States. Psychiatric expertise and effective mental health treatment options, particular those used to address the rising suicide epidemic among adolescents, are needed in the ED.