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. 2014 Apr;133(4):602-9.
doi: 10.1542/peds.2013-3165. Epub 2014 Mar 17.

Common and costly hospitalizations for pediatric mental health disorders

Naomi S Bardach  1 , Tumaini R Coker, Bonnie T Zima, J Michael Murphy, Penelope Knapp, Laura P Richardson, Glenace Edwall, Rita Mangione-Smith
Affiliations

Common and costly hospitalizations for pediatric mental health disorders

Naomi S Bardach et al. Pediatrics. 2014 Apr.

Abstract

Background and objectives: Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children's hospitals.

Methods: We examined all discharges in 2009 for patients aged 3 to 20 years in the nationally representative Kids' Inpatient Database (KID) and in the Pediatric Health Information System (free-standing children's hospitals). Main outcomes were frequency of International Classification of Diseases, Ninth Revision, Clinical Modification-defined mental health diagnostic groupings (primary and nonprimary diagnosis) and, using KID, resource utilization (defined by diagnostic grouping aggregate annual charges).

Results: Nearly 10% of pediatric hospitalizations nationally were for a primary mental health diagnosis, compared with 3% of hospitalizations at free-standing children's hospitals. Predictors of hospitalizations for a primary mental health problem were older age, male gender, white race, and insurance type. Nationally, the most frequent and costly primary mental health diagnoses were depression (44.1% of all mental health admissions; $1.33 billion), bipolar disorder (18.1%; $702 million), and psychosis (12.1%; $540 million).

Conclusions: We identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis. These diagnoses can be used as priority conditions for pediatric mental health inpatient quality measurement.

Keywords: bipolar disorder; child mental health; costs; depression; pediatric hospitalization; psychosis.

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Figures

FIGURE 1
FIGURE 1
Resource utilization for the most common primary inpatient mental health diagnoses for 3- to 20-year-olds nationally. bill, billion; mill, million.
See this image and copyright information in PMC

References

    1. Shaffer D, Fisher P, Dulcan MK, et al. . The NIMH Diagnostic Interview Schedule for Children version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. J Am Acad Child Adolesc Psychiatry. 1996;35(7):865–877 - PubMed
    1. Costly mental disorders affect millions of us children and teens: News from the centers for disease control and prevention. JAMA. 2013;310(1):23
    1. Perou R, Bitsko RH, Blumberg SJ, et al. Centers for Disease Control and Prevention . Mental health surveillance among children—United States, 2005-2011. MMWR Surveill Summ. 2013;62(2 suppl 2):1–35 - PubMed
    1. Health Cost Institute. Children’s Health Care Spending Report: 2007–2010. July 2012. Available at: www.healthcostinstitute.org/files/HCCI_CHCSR20072010.pdf. Accessed May 29, 2013
    1. Pfuntner A, Wier LM, Stocks C. Most frequent conditions in U.S. hospitals, 2010. Statistical brief no. 148. AHRQ HCUP Statistical Briefs; January 2013. Available at: www.hcup-us.ahrq.gov/reports/statbriefs/sb148.pdf. Accessed May 29, 2013

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