Hospitalization Outcomes for Rural Children with Mental Health Conditions.

Bettenhausen, Jessica L; Hall, Matt; Doupnik, Stephanie K; Markham, Jessica L; Feinstein, James A; Berry, Jay G; Gay, James C

Bettenhausen, Jessica L; Hall, Matt; Doupnik, Stephanie K; Markham, Jessica L; Feinstein, James A; Berry, Jay G; Gay, James C.

Afiliação

Bettenhausen JL; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO. Electronic address: jlbettenhausen@cmh.edu.
Hall M; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO; Children's Hospital Association, Lenexa, KS.
Doupnik SK; Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
Markham JL; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
Feinstein JA; Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
Berry JG; Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Gay JC; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.

J Pediatr ; 229: 240-246.e1, 2021 02.

Article em En | MEDLINE | ID: mdl-33010261

RESUMO

OBJECTIVE: To identify where rural children with mental health conditions are hospitalized and to determine differences in outcomes based on location of hospitalization. STUDY DESIGN: This is a retrospective cohort analysis of US rural children aged 0-18 years with a mental health hospitalization between January 1, 2014, and November 30, 2014, using the 2014 Agency for Healthcare Research and Quality's Nationwide Readmissions Database. Hospitalizations for rural children were categorized by children's hospitals, metropolitan non-children's hospitals, or rural hospitals. Associations between hospital location and outcomes were assessed with logistic (readmission) and negative binomial regression (length of stay [LOS]) models. Classification and regression trees (CART) were used to describe the characteristics of most common hospitalizations at a rural hospital. RESULTS: Of 21 666 mental health hospitalizations of rural children, 20.6% were at rural hospitals. After adjustment for clinical and demographic characteristics, LOS was higher at metropolitan non-children's and children's hospitals compared with rural hospitals (LOS: adjusted rate ratio [aRR], 1.35 [95% CI 1.29-1.41] and 1.33 [95% CI, 1.25-1.41]; P < .01 for all). The 30-day readmission was lower at metropolitan non-children's and children's hospitals compared with rural hospitals (aOR, 0.73 [95% CI, 0.63-0.84] and 0.59 [95% CI, 0.48-0.71]; P < .001 for all). Adolescent males living in poverty with externalizing behavior disorder had the highest percentage of hospitalization at rural hospitals (69.4%). CONCLUSIONS: Although hospitalizations at children's and metropolitan non-children's hospitals were longer, patient outcomes were more favorable.

Assuntos

Hospitalização; Transtornos Mentais/terapia; Adolescente; Criança; Pré-Escolar; Estudos de Coortes; Feminino; Humanos; Lactente; Masculino; Estudos Retrospectivos; População Rural; Estados Unidos

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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hospitalização / Transtornos Mentais Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos

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