Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19

Abstract Objectives To characterize trends in pediatric mental health visit counts, including visits for prolonged length of stay (LOS), in a sample of emergency departments (EDs) from 29 states during COVID‐19. Methods We performed a secondary analysis of the Clinical Emergency Data Registry from J...

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Main Authors: Alexander T. Janke, Katherine A. Nash, Pawan Goyal, Marc Auerbach, Arjun K. Venkatesh
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Journal of the American College of Emergency Physicians Open
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Online Access:https://doi.org/10.1002/emp2.12869
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author Alexander T. Janke
Katherine A. Nash
Pawan Goyal
Marc Auerbach
Arjun K. Venkatesh
author_facet Alexander T. Janke
Katherine A. Nash
Pawan Goyal
Marc Auerbach
Arjun K. Venkatesh
author_sort Alexander T. Janke
collection DOAJ
description Abstract Objectives To characterize trends in pediatric mental health visit counts, including visits for prolonged length of stay (LOS), in a sample of emergency departments (EDs) from 29 states during COVID‐19. Methods We performed a secondary analysis of the Clinical Emergency Data Registry from January 2020 through December 2021. We reported trends in pediatric mental health visit counts overall and for those with prolonged ED LOS. We reported incident rate ratios (IRRs) for monthly counts compared to January 2020. Among visits with LOS >24 hours, we reported on the most common diagnostic categories. Results There were 107 EDs from 29 states with available complete data in 2020 and 2021. Pediatric mental health visit counts resulting in a LOS greater than 6, 12, and 24 hours were higher for much of 2021. At their peak, there were 604 visits with LOS >12 hours (IRR, 2.14; 95% confidence interval [CI], 1.86–2.47) and 262 visits (IRR, 2.46; 95% CI, 1.97–3.09) with LOS >24 hours in April 2021. Pediatric mental health visits with LOS >12 hours and >24 hours made up 20.9% and 7.3% of pediatric mental health visits overall, respectively. For visits with ED LOS >24 hours, the most common diagnostic categories were suicide or self‐injury, depressive disorders, and mental health syndrome. Conclusions In this sample of 107 EDs in 29 states, visit counts with prolonged LOS >24 hours more than doubled in some months since the arrival of COVID‐19. These findings are indicative of an increasingly strained emergency and mental health system.
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spelling doaj-art-ba2a78ef7b3144e9b883a50a5ebb472b2025-08-20T03:23:26ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-12-0136n/an/a10.1002/emp2.12869Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19Alexander T. Janke0Katherine A. Nash1Pawan Goyal2Marc Auerbach3Arjun K. Venkatesh4Institute for Healthcare Policy and Innovation VA Ann Arbor/University of Michigan Ann Arbor Michigan USADepartment of Pediatrics NewYork‐Presbyterian/Columbia University Irving Medical Center New York New York USAAmerican College of Emergency Physicians Dallas Texas USADepartments of Emergency Medicine and Pediatrics Yale University School of Medicine New Haven Connecticut USADepartment of Emergency Medicine Yale School of Medicine New Haven Connecticut USAAbstract Objectives To characterize trends in pediatric mental health visit counts, including visits for prolonged length of stay (LOS), in a sample of emergency departments (EDs) from 29 states during COVID‐19. Methods We performed a secondary analysis of the Clinical Emergency Data Registry from January 2020 through December 2021. We reported trends in pediatric mental health visit counts overall and for those with prolonged ED LOS. We reported incident rate ratios (IRRs) for monthly counts compared to January 2020. Among visits with LOS >24 hours, we reported on the most common diagnostic categories. Results There were 107 EDs from 29 states with available complete data in 2020 and 2021. Pediatric mental health visit counts resulting in a LOS greater than 6, 12, and 24 hours were higher for much of 2021. At their peak, there were 604 visits with LOS >12 hours (IRR, 2.14; 95% confidence interval [CI], 1.86–2.47) and 262 visits (IRR, 2.46; 95% CI, 1.97–3.09) with LOS >24 hours in April 2021. Pediatric mental health visits with LOS >12 hours and >24 hours made up 20.9% and 7.3% of pediatric mental health visits overall, respectively. For visits with ED LOS >24 hours, the most common diagnostic categories were suicide or self‐injury, depressive disorders, and mental health syndrome. Conclusions In this sample of 107 EDs in 29 states, visit counts with prolonged LOS >24 hours more than doubled in some months since the arrival of COVID‐19. These findings are indicative of an increasingly strained emergency and mental health system.https://doi.org/10.1002/emp2.12869emergency department crowdinglength of staymental healthpediatrics
spellingShingle Alexander T. Janke
Katherine A. Nash
Pawan Goyal
Marc Auerbach
Arjun K. Venkatesh
Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
Journal of the American College of Emergency Physicians Open
emergency department crowding
length of stay
mental health
pediatrics
title Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
title_full Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
title_fullStr Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
title_full_unstemmed Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
title_short Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
title_sort pediatric mental health visits with prolonged length of stay in community emergency departments during covid 19
topic emergency department crowding
length of stay
mental health
pediatrics
url https://doi.org/10.1002/emp2.12869
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