Developing Measures of Quality for the Emergency Department Management of Pediatric Suicide-Related Behaviors

Rhodes, Anne E.; Bethell, Jennifer; Newton, Amanda S; Antony, Jesmin; Bhanji, Farhan; Chaulk, David; Curtis, Sarah; Gouin, Serge; Joubert, Gary; Porter, Robert D.; Silver, Norman; Spruyt, J. L. L.; Thompson, Graham C.; Turner, Troy

doi:10.1097/pec.0b013e3182712981

Cited by 6 publications

(1 citation statement)

References 16 publications

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“…Documentation of mental health evaluation and follow-up appointments have been proposed as potential quality of care measures in the emergency department management of suicidal behavior. 28 These findings suggest important opportunities to improve the care of youth with suicidal behavior.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Disposition of Medicaid-Insured Children and Adolescents With Suicide Attempts

Williams

Balmer

Dudley

et al. 2015

Academic Pediatrics

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Objective Guidelines and quality of care measures for the evaluation of adolescent suicidal behavior recommend prompt mental health evaluation, hospitalization of high-risk youth, and specific follow-up plans—all of which may be influenced by sociodemographic factors. The aims of this study were to identify sociodemographic characteristics associated with variations in the evaluation of youth with suicidal behavior. Methods We conducted a large cohort study of youth, ages 7–18, enrolled in Tennessee Medicaid from 1995–2006, who filled prescriptions for antidepressants and who presented for evaluation of injuries that were determined to be suicidal based on external cause-of-injury codes (E-codes) and ICD-9-CM codes and review of individual medical records. Chi-square tests and logistic regression were performed to assess the relationship between sociodemographic characteristics and documentation of mental health evaluation, hospitalization and discharge instructions. Results Of 929 episodes of suicidal behavior evaluated in an acute setting, rural-residing youth were less likely to be admitted to a psychiatric hospital (AOR 0.72; 95% CI 0.55–0.95) and more likely to be medically hospitalized only (AOR 1.92; 95% CI 1.39–2.65). Females were less likely to be admitted to a psychiatric hospital (AOR 0.55; 95% CI 0.41–0.74) and more likely to be discharged home (AOR 1.44; 95% CI 1.01–2.04). Only 40% of those discharged to home had documentation of discharge instructions with both follow-up provider and date. Conclusions In this statewide cohort of youth with suicidal behavior, there were significant differences in disposition associated with sociodemographic characteristics.

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Section: Discussionmentioning

confidence: 99%