Health Service Utilization in Pediatric Mental Health Populations: A Cost Analysis Study

Objective: From 2007 to 2010, inpatient admissions increased for pediatric patients suffering from mental health disorders by 24% (Health Care Cost Institute, 2012). Nationally, an estimated 20% of children and adolescents meet diagnostic criteria for a mental health disorder, and it is estimated that the treatment of these children costs $247 billion annually (Perou et al, 2013). However, limited studies have examined the mental health service utilization of pediatric patients. The purpose of this study is to examine pediatric mental health utilization at a large, psychiatric safety-net hospital and describe demographic, service delivery, and clinical factors associated with an increased likelihood of multiple psychiatric hospitalizations. Methods: In this retrospective study, descriptive and univariate logistic regression analyses were conducted in a sample of 4027 pediatric patients who were admitted to a public psychiatric hospital in the United States from 1 January 2010 to 31 December 2015. Results: Our study found 50.6% of pediatric patients hospitalized during the study period were uninsured. Many of these children and adolescents were likely eligible for government programs such as Medicaid or CHIP but were not enrolled. Among our sample, 75.8% reported attending regular classes at school while 24.2% were not regularly attending school prior to his or her hospitalization. 37.99% of the hospitalized patients had a history of aggression and 28.67% had a history of suicidal ideations. 13.25% of the hospitalized patients suffered from Major Depressive Disorder and 13.34% suffered from Bipolar Disorder. We also found 25.3% of pediatric patients were re-hospitalized within our five-year time period. This value ranged from one to sixteen visits during this time-period. Length of stay and age at admission were found to be negatively correlated with re-hospitalization within this five-year period. Conclusion: We found that half of the pediatric patients lacked health insurance, which may have impeded access to outpatient mental health services. These patients lacked insurance, regular school attendance, and support at home. To reduce the burden on the healthcare system, new strategies must be created to increase parent and patient education, medication adherence, and outpatient engagement