Children's Mental Health Visits to the Emergency Department: Factors Affecting Wait Times and Length of Stay.

Amanda S Newton, Sachin Rathee, Simran Grewal, Nadia Dow, Rhonda J Rosychuk
Author Information
  1. Amanda S Newton: Faculty of Medicine & Dentistry, University of Alberta, Edmonton Clinic Health Academy (ECHA), 11405-87 Avenue, Room 3-526, Edmonton, AB, Canada T6G 1C9.
  2. Sachin Rathee: Faculty of Medicine & Dentistry, University of Alberta, WC Mackenzie Health Sciences Centre, Edmonton, AB, Canada T6G 2R7. ORCID
  3. Simran Grewal: Faculty of Medicine & Dentistry, University of Alberta, Edmonton Clinic Health Academy (ECHA), 11405-87 Avenue, Room 3-582B, Edmonton, AB, Canada T6G 1C9.
  4. Nadia Dow: Faculty of Medicine & Dentistry, University of Alberta, Edmonton Clinic Health Academy (ECHA), 11405-87 Avenue, Room 3-582, Edmonton, AB, Canada T6G 1C9.
  5. Rhonda J Rosychuk: Faculty of Medicine & Dentistry, University of Alberta, Edmonton Clinic Health Academy (ECHA), 11405-87 Avenue, Room 3-524, Edmonton, AB, Canada T6G 1C9.

Abstract

Objective. This study explores the association of patient and emergency department (ED) mental health visit characteristics with wait time and length of stay (LOS). Methods. We examined data from 580 ED mental health visits made to two urban EDs by children aged ≤18 years from April 1, 2004, to March 31, 2006. Logistic regressions identified characteristics associated with wait time and LOS using hazard ratios (HR) with 95% confidence intervals (CIs). Results. Sex (male: HR = 1.48, 95% CI = 1.20-1.84), ED type (pediatric ED: HR = 5.91, 95% CI = 4.16-8.39), and triage level (Canadian Triage and Acuity Scale (CTAS) 2: HR = 3.62, 95% CI = 2.24-5.85) were statistically significant predictors of wait time. ED type (pediatric ED: HR = 1.71, 95% CI = 1.18-2.46), triage level (CTAS 5: HR = 2.00, 95% CI = 1.15-3.48), number of consultations (HR = 0.46, 95% CI = 0.31-0.69), and number of laboratory investigations (HR = 0.75, 95% CI = 0.66-0.85) predicted LOS. Conclusions. Based on our results, quality improvement initiatives to reduce ED waits and LOS for pediatric mental health visits may consider monitoring triage processes and the availability, access, and/or time to receipt of specialty consultations.

References

  1. Emerg Med J. 2011 Aug;28(8):658-61 [PMID: 20668112]
  2. J Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1110-9 [PMID: 22023999]
  3. Pediatr Emerg Care. 2009 Apr;25(4):217-20 [PMID: 19382317]
  4. Prehosp Emerg Care. 2006 Oct-Dec;10(4):440-6 [PMID: 16997771]
  5. Int J Adolesc Med Health. 2008 Oct-Dec;20(4):513-8 [PMID: 19230451]
  6. Gen Hosp Psychiatry. 2012 Jul-Aug;34(4):403-9 [PMID: 22516215]
  7. Can J Rural Med. 2010 Fall;15(4):153-5 [PMID: 20875314]
  8. J Emerg Nurs. 2009 Nov;35(6):509-14 [PMID: 19914473]
  9. Pediatr Emerg Care. 2010 Feb;26(2):99-106 [PMID: 20094002]
  10. Pediatrics. 2002 Oct;110(4):e40 [PMID: 12359813]
  11. Pediatr Emerg Care. 2007 Feb;23(2):94-102 [PMID: 17351408]
  12. Health Serv Res. 2009 Dec;44(6):2022-39 [PMID: 19732167]
  13. Pediatr Emerg Care. 2011 Mar;27(3):170-3 [PMID: 21346682]
  14. Pediatr Emerg Care. 2006 Feb;22(2):85-9 [PMID: 16481922]
  15. Adv Emerg Nurs J. 2012 Jan-Mar;34(1):65-74 [PMID: 22313903]
  16. Acad Emerg Med. 2010 Feb;17(2):177-86 [PMID: 20370747]
  17. Pediatr Emerg Care. 2011 Apr;27(4):295-300 [PMID: 21490544]
  18. Pediatr Emerg Care. 2011 Feb;27(2):110-5 [PMID: 21252810]
  19. Health Aff (Millwood). 2008 Mar-Apr;27(2):w84-95 [PMID: 18198184]
  20. Med Care. 2012 Apr;50(4):335-41 [PMID: 22270097]
  21. J Can Acad Child Adolesc Psychiatry. 2010 Nov;19(4):290-6 [PMID: 21037920]
  22. J Clin Psychiatry. 2009 Aug;70(8):1164-77 [PMID: 19758526]
  23. Pediatr Emerg Care. 2011 Apr;27(4):275-83 [PMID: 21490541]
  24. Pediatrics. 2006 Oct;118(4):1764-7 [PMID: 17015573]
  25. J Emerg Nurs. 2003 Jun;29(3):229-39 [PMID: 12776078]
  26. Pediatrics. 2011 May;127(5):e1356-66 [PMID: 21518712]
  27. Pediatr Emerg Care. 2004 Nov;20(11):742-8 [PMID: 15502655]
  28. CJEM. 2010 Jan;12(1):50-7 [PMID: 20078919]
  29. Arch Intern Med. 2009 Nov 9;169(20):1857-65 [PMID: 19901137]
  30. CJEM. 2009 Sep;11(5):447-54 [PMID: 19788789]
  31. Am J Med Qual. 1997 Winter;12(4):183-6 [PMID: 9385728]
  32. Pediatr Emerg Care. 2009 Dec;25(12):835-40 [PMID: 19952972]
  33. Pediatr Emerg Care. 2009 Jun;25(6):380-6 [PMID: 19458565]
  34. Paediatr Child Health. 2013 Jun;18(6):e26-31 [PMID: 24421704]
  35. Acad Emerg Med. 2011 Dec;18(12):1295-302 [PMID: 22168194]
  36. CJEM. 2009 Jan;11(1):23-8 [PMID: 19166636]
  37. CJEM. 2008 May;10(3):224-43 [PMID: 19019273]
  38. Pediatrics. 2005 Mar;115(3):e310-5 [PMID: 15741357]
  39. West J Emerg Med. 2010 Feb;11(1):10-5 [PMID: 20411067]
  40. Pediatr Emerg Care. 2002 Aug;18(4):268-70 [PMID: 12187132]
  41. East Mediterr Health J. 2009 Mar-Apr;15(2):416-24 [PMID: 19554989]
  42. Pediatr Emerg Care. 2009 Nov;25(11):715-20 [PMID: 19864967]
  43. Acad Emerg Med. 2007 Aug;14(8):702-8 [PMID: 17656607]
  44. Aust Health Rev. 1998;21(3):133-49 [PMID: 10185681]

Word Cloud

Created with Highcharts 10.0.0=HR95%CI1EDtimeLOS0mentalhealthwaitpediatrictriagecharacteristicsvisits48typeED:levelCTAS28546numberconsultationsObjectivestudyexploresassociationpatientemergencydepartmentvisitlengthstayMethodsexamineddata580madetwourbanEDschildrenaged≤18yearsApril2004March312006LogisticregressionsidentifiedassociatedusinghazardratiosconfidenceintervalsCIsResultsSexmale:20-184591416-839CanadianTriageAcuityScale2:36224-5statisticallysignificantpredictors7118-25:0015-331-069laboratoryinvestigations7566-0predictedConclusionsBasedresultsqualityimprovementinitiativesreducewaitsmayconsidermonitoringprocessesavailabilityaccessand/orreceiptspecialtyChildren'sMentalHealthVisitsEmergencyDepartment:FactorsAffectingWaitTimesLengthStay

Similar Articles

Cited By