Evaluation of disparities of pediatric mental health care in US emergency departments

Alarming trends of increasing US Emergency Department (ED) visits for children with mental health disorders have been reported. The National Pediatric Readiness Project (NPRP) is a nationally representative federally funded initiative that scores EDs on their preparedness to treat children. Based on NPRP data less than 1/3rd of low pediatric volume EDs are prepared to treat children and pediatric morbidity and mortality are poorer at these EDs. Unfortunately 2/3rds of children presenting to EDs for mental health disorders present to low pediatric volume EDs that are less likely to be prepared to treat children thereby furthering disparities in health outcomes. This work will help inform best practices for resource allocation and educate providers on evidence-based care for children presenting to EDs with mental health disorders. This issue aligns with the MCHB Strategic Research issues: 9 - Adolescent Well Visits and Preventative Services 10 - Bullying 12 - Transition to Adulthood and 15 - Adequate Insurance Coverage. Research Design: Retrospective cohort study utilizing 2013 and 2016 HCUP SEDD SID AHA annual survey data and the NPRP 2013 assessment data for the following states: Arkansas Florida Georgia Iowa Maryland Massachusetts Nebraska New York Utah Vermont and Wisconsin. Methods: Aim 1: Evaluate the association between the pediatric readiness scores of EDs and outcomes (e.g. readmission transfer LOS) among children with mental health disorders presenting to US EDs. Aim 2: Compare the disparities in outcomes (e.g. readmission LOS ED recidivism distance transferred and distance to a higher level psychiatric care center) between adults and children with similar mental health disorders presenting to US EDs. Participant Information: Children 5-17 years and adults 18 years and older of both genders who present to the Emergency Department for a mental health disorder in 2013 or 2016. Name of Databases: AHRQ Health Care Utilization Project's State Emergency Department Databases and State Inpatient Databases [Arkansas Florida Georgia Iowa Maryland Massachusetts Nebraska New York Utah Vermont and Wisconsin] (2013 & 2016); American Hospital Association Annual Survey (2013 & 2016); National Pediatric Readiness Project assessment data (2013)