@article{ref1,
title="Five-year trends in pediatric mental health emergency department visits in Massachusetts: a population-based cohort study",
journal="Journal of pediatrics",
year="2022",
author="Lin, Meng-Yun and Kim, Jihye and Sheldrick, R. Christopher and Bair-Merritt, Megan H. and Durham, Michelle P. and Feinberg, Emily and Cole, Megan B.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To evaluate temporal changes in pediatric emergency department (ED) visits for mental health problems in Massachusetts based on diagnoses and patient characteristics and to assess trends in all-cause pediatric ED visits. STUDY DESIGN: This statewide, population-based retrospective cohort study used the Massachusetts All-Payer Claims Database, which includes almost all Massachusetts residents. The study sample consisted of residents under age 21 who were enrolled in a health plan from 2013-2017. Using multivariate regressions, we examined temporal trends in mental health-related and all-cause ED visits from 2013-2017, with person-quarter as the unit of analysis; we also estimated differential trends by sociodemographic and diagnostic subgroups. The outcomes were number of mental health-related (any diagnosis, plus 14 individual diagnoses) and all-cause ED visits/1000 patients/quarter. <br><br>RESULTS: Of the 967,590 Massachusetts residents in our study (14.8 million person-quarters), mean age was 8.1 years, 48% were female, and 57% had Medicaid coverage. For this population, mental health (any) and all-cause ED visits decreased from 2013-2017 (p<0.001). Those 18-21 years experienced the largest declines in mental health-related (63.0% decrease) and all-cause (60.9% decrease) ED visits. Although mental health ED visits declined across most diagnostic subgroups, ED visits with autism spectrum disorder and suicidal-related diagnoses increased by 108% and 44%, respectively. <br><br>CONCLUSIONS: Overall rates of pediatric ED visits with mental health diagnoses in Massachusetts declined from 2013 to 2017, although ED visits with autism- and suicide-related diagnoses increased. Massachusetts' policies and care delivery models aimed at pediatric mental health may hold promise, although there are important opportunities for improvement.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2022.03.011",
url="http://dx.doi.org/10.1016/j.jpeds.2022.03.011"
}