Are There Differences in Pediatric Psychiatric Emergency Department Patients Related to Utilization Frequency?

Objectives The increasing frequency of visits to the pediatric psychiatric emergency department in the United States signals a need for a better understanding of factors contributing to more frequent utilization. This study examined characteristics of patients associated with higher utilization of the pediatric psychiatric emergency department to increase understanding of this group of patients. Methods This was a retrospective observational study. Data were abstracted from the electronic medical record system from January 2012 to December 2017 for patients with a completed mental health consultation. There were 8504 total encounters for 6950 unique patients during this period. Analyses were conducted to test associations between maximum number of visits in any 1-year period for each patient and demographic and clinical factors. Results Younger age was independently associated with greater mean number of visits within any 1 year. No independent associations were found between maximum number of visits within 1 year and sex, race, language, insurance type, distance from emergency department, time spent in the emergency department, or reason for visit. Conclusions The greater emergency department use by younger children found in this study may be an indicator of insufficient treatment at other levels of care. Additional research examining more demographic variables and demographic characteristics in greater detail is needed to fully characterize the most frequent users of costly pediatric psychiatric emergency department care.