@article{ref1,
title="Quality of care for youth hospitalized for suicidal ideation and self-harm: quality of inpatient care for suicidal ideation",
journal="Academic pediatrics",
year="2021",
author="Mangione-Smith, Rita and Williams, Derek and Basco, William T. and Yung, Steven and Gidengil, Courtney A. and Parast, Layla and Tolpadi, Anagha and Burkhart, Q. and Connell, Sarah K. and McGalliard, Julie and Bardach, Naomi and Wood, Kelly E. and Brittan, Mark and Britto, Maria T.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To examine performance on quality measures for pediatric inpatient suicidal ideation/self-harm care, and whether performance is associated with reutilization. <br><br>METHODS: Retrospective observational eight hospital study of patients [N=1090] aged 5-17 years hospitalized for suicidal ideation/self-harm between 9/1/14-8/31/16. Two medical records-based quality measures assessing suicidal ideation/self-harm care were evaluated, one on counseling caregivers regarding restricting access to lethal means and the other on communication between inpatient and outpatient providers regarding the follow-up plan. Multivariable logistic regression assessed associations between quality measure scores and 1) hospital site, 2) patient demographics, and 3) 30-day emergency department return visits and inpatient readmissions. <br><br>RESULTS: Medical record documentation revealed that, depending on hospital site, 17% - 98% of caregivers received lethal means restriction counseling (mean 70%); inpatient-to-outpatient provider communication was documented in 0-51% of cases (mean 16%). The odds of documenting receipt of lethal means restriction counseling was higher for caregivers of female patients compared to caregivers of male patients (aOR 1.51, 95% confidence interval [CI]: 1.07-2.14). The odds of documenting inpatient-to-outpatient provider follow-up plan communication was lower for Black patients compared to White patients (aOR 0.45, 95% CI: 0.24-0.84). All-cause 30-day readmission was lower for patients with documented caregiver receipt of lethal means restriction counseling (aOR 0.48, 95% CI: 0.28-0.83). <br><br>CONCLUSIONS: This study revealed disparities and deficits in the quality of care received by youth with suicidal ideation/self-harm. Providing caregivers lethal means restriction counseling prior to discharge may help to prevent readmission.<p /> <p>Language: en</p>",
language="en",
issn="1876-2859",
doi="10.1016/j.acap.2021.05.019",
url="http://dx.doi.org/10.1016/j.acap.2021.05.019"
}