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PEDIATRICS Vol. 110 No. 4 October 2002, pp. e40

ELECTRONIC ARTICLE

Summary Statistics for Pediatric Psychiatric Visits to US Emergency Departments, 1993–1999

Marion R. Sills, MD, MPH and Shayne D. Bland, MSc{dagger}

Department of Emergency Medicine, Children’s Hospital of Denver and University of Colorado Health Sciences Center, Denver, Colorado

--> Objectives. To describe characteristics of emergency department (ED) encounters for pediatric patients with an acute mental health diagnosis.

Methods. Data are from the National Hospital Ambulatory Medical Care Survey, which includes abstracts from the medical records of a national probability sample of visits to EDs. Analysis was limited to records of patients who were younger than 19 years and had a diagnosis of either confirmed or suspected mental disorder or a suicide attempt.

Results. There was an estimated annual average of 434 000 ED pediatric mental health visits from 1993 to 1999, an average annual rate of 326.8 visits per 10 000 people. Visit rates varied by patient’s region, age, race, and gender. Psychosis was the diagnosis in 10.8% of these patients, and suicide attempt was the diagnosis in 13.6%. ED pediatric mental health visits accounted for 1.6% of all ED visits in this age group.

Conclusions. The significant increase in emergency department pediatric mental health (EDPMH) visits from 1993–1999 is greatest among patients who are non-white, teenaged, female, and live in the Northeast or Midwest. This variation in EDPMH visits may reflect variability in the shortage of mental health providers. The lack of increase in the 2 categories of diagnoses mandatorily seen in EDs—psychoses and suicide attempts—suggests that the overall rise in EDPMH visits may have been attributable to nonurgent complaints more appropriately managed by a primary mental health provider.

Key Words: emergency services • emergency services • psychiatric • emergency medicine • mental disorders diagnosed in childhood • National Hospital Ambulatory Medical Care Survey

Abbreviations: ED, emergency department • EDPMH, emergency department pediatric mental health (visit) • NHAMCS, National Hospital Ambulatory Medical Care Survey • PSU, primary sampling unit; ESA, emergency service area • ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification

Received for publication Apr 11, 2002; Accepted Jun 26, 2002.




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