Association of Race/Ethnicity and Social Determinants with Rehospitalization for Mental Health Conditions at Acute Care Children's Hospitals - 21/12/21
, Matt Hall, PhD 2, Charlotte M. Brown, MD 1, David P. Johnson, MD 1, James W. Antoon, MD, PhD 1, Heather Kreth, PsyD 1, My-Linh Ngo, MD 1, Whitney Browning, MD 1, Maya Neeley, MD 1, Alison Herndon, MD, MSPH 1, Swati B. Chokshi, MD 1, Gregory Plemmons, MD 1, Jakobi Johnson, BS 1, Sarah R. Hart, APRN 1, Derek J. Williams, MD, MPH 1Abstract |
Objective |
To evaluate associations of race/ethnicity and social determinants with 90-day rehospitalization for mental health conditions to acute care nonpsychiatric children's hospitals.
Study design |
We conducted a retrospective cohort analysis of mental health hospitalizations for children aged 5-18 years from 2016 to 2018 at 32 freestanding US children's hospitals using the Children's Hospital Association's Pediatric Health Information System database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Risk factors for rehospitalization were modeled using mixed-effects multivariable logistic regression.
Results |
Among 23 556 index hospitalizations, there were 1382 mental health rehospitalizations (5.9%) within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children (aOR 1.26, 95% CI 1.08-1.48). Those with government insurance were 18% more likely to be rehospitalized than those with private insurance (aOR 1.18, 95% CI 1.04-1.34). In contrast, those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location (suburban: aOR 0.78, 95% CI 0.63-0.97).
Conclusions |
Non-Hispanic Black children and those with public insurance were at greatest risk for 90-day rehospitalization, and risk was lower in those residing in suburban locations. Future work should focus on upstream interventions that will best attenuate social disparities to promote equity in pediatric mental healthcare.
Le texte complet de cet article est disponible en PDF.Abbreviations : CAMHD-CS, PHIS
Plan
| A.C. was supported by the Agency for Healthcare Research and Quality (T32HS026122). J.A. was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (K12 HL137943). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or the National Heart, Lung, and Blood Institute of the National Institutes of Health. The Agency for Healthcare Research and Quality and the National Institutes of Health had no role in the design and conduct of the study. The authors declare no conflicts of interest. |
Vol 240
P. 228 - janvier 2022 Retour au numéro
Article précédent
- Increasing Guideline-Concordant Durations of Antibiotic Therapy for Acute Otitis Media
- Holly M. Frost, Yingbo Lou, Amy Keith, Andrew Byars, Timothy C. Jenkins
- Improving the Quality of Clinical Care of Children with Diabetic Ketoacidosis in General Emergency Departments Following a Collaborative Improvement Program with an Academic Medical Center
- Hani Alsaedi, Riad Lutfi, Samer Abu-Sultaneh, Erin E. Montgomery, Kellie J. Pearson, Elizabeth Weinstein, Travis Whitfill, Marc A. Auerbach, Kamal Abulebda
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?