Trends in Visits and Costs for Mental Health Emergencies in a Pediatric Emergency Department, 2010–2016

Hoffmann, Jennifer A.; Stack, Anne M.; Samnaliev, Mihail; Monuteaux, Michael C.; Lee, Lois K.

doi:10.1016/j.acap.2019.02.006

Cited by 42 publications

(31 citation statements)

References 34 publications

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“…This may be explained by the fact that significant portions of pediatric mental health evaluations come from school referrals with school-related stress [31,32]. Studies have demonstrated a direct correlation between mental health visits to the PED and school attendance [32][33][34], though pandemic related stress, which will continue to be part of our new normal, may have different referral patterns. Our study period is likely not long enough to reflect any long term changes in patterns of utilization of mental health services.…”

Section: Discussionmentioning

confidence: 99%

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

Levene

Fein

Silver

et al. 2021

The American Journal of Emergency Medicine

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Background: The Bronx has the highest prevalence of asthma in the United States (US), and was also an early COVID-19 epicenter, making it a unique study location. Worldwide reports describe significant declines in pediatric emergency department (PED) visits during COVID-19. The ongoing impact of COVID-19 on all PED presentations, including asthma, at an early epicenter has not been studied beyond the pandemic peak and into the early phases of state re-opening. Objectives: To compare PED health-seeking behaviors and clinical characteristics during the 2020 pandemic and subsequent initial New York State (NYS) phased re-opening to the same period in 2019. Methods: Retrospective chart review of children <21 years utilizing the PED at a high-volume quaternary children's hospital in The Bronx, NY from March 15th 2020 -July 6th 2020 (pandemic cohort) and the same interval in 2019 (comparison cohort). Visits were assigned to pre-determined diagnostic categories. Demographic and clinical data were compared. Results: 19,981 visits were included. Visits declined by 66% during 2020. Proportions of asthma visits (2% vs. 7%, p < 0.0001) and minor medical problems (61% vs. 67%, p < 0.0001) had significant declines in the pandemic cohort, while major medical problems (13% vs. 8%, p < 0.0001), appendicitis (1% vs. 0.4%, p < 0.0001) and other surgical complaints (1% vs. 0.5%, p < 0.0001) had proportional increases in the pandemic cohort. No significant proportional changes were noted among psychosocial and trauma groups between the two cohorts. Conclusion:The pandemic cohort experienced a substantial decrease in PED volume, but an increase in acuity and admission rates, which was sustained through the NYS phase-II re-opening. Despite being located in an asthma hub, the incidence of asthma-related PED visits declined appreciably in the pandemic cohort. Future studies examining the effects of indoor allergens in isolation on pediatric asthma are warranted.

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Section: Discussionmentioning

confidence: 99%

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

Levene

Fein

Silver

et al. 2021

The American Journal of Emergency Medicine

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“…Asthma is a common chronic disease in childhood, responsible for ∼1.7 million emergency department (ED) visits annually in the United States. 1 Anxiety and depression are also increasingly common causes of pediatric health care use [2][3][4] and are common pediatric mental health conditions. Anxiety prevalence is estimated to be between 6% and 13% in children ,18 years of age, 5 and depression prevalence ranges from 2% in prepubertal children to 5% to 8% in adolescents.…”

mentioning

confidence: 99%

Depression, Anxiety, and Emergency Department Use for Asthma

et al. 2019

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BACKGROUND AND OBJECTIVES: Asthma is responsible for ∼1.7 million emergency department (ED) visits annually in the United States. Studies in adults have shown that anxiety and depression are associated with increased asthma-related ED use. Our objective was to assess this association in pediatric patients with asthma. METHODS: We identified patients aged 6 to 21 years with asthma in the Massachusetts All-Payer Claims Database for 2014 to 2015 using International Classification of Diseases, Ninth and 10th Revision codes. We examined the association between the presence of anxiety, depression, or comorbid anxiety and depression and the rate of asthma-related ED visits per 100 child-years using bivariate and multivariable analyses with negative binomial regression. RESULTS: Of 65 342 patients with asthma, 24.7% had a diagnosis of anxiety, depression, or both (11.2% anxiety only, 5.8% depression only, and 7.7% both). The overall rate of asthma-related ED use was 17.1 ED visits per 100 child-years (95% confidence interval [CI]: 16.7-17.5). Controlling for age, sex, insurance type, and other chronic illness, patients with anxiety had a rate of 18.9 (95% CI: 17.0-20.8) ED visits per 100 child-years, patients with depression had a rate of 21.7 (95% CI: 18.3-25.0), and patients with both depression and anxiety had a rate of 27.6 (95% CI: 24.8-30.3). These rates were higher than those of patients who had no diagnosis of anxiety or depression (15.5 visits per 100 child-years; 95% CI: 14.5-16.4; P , .001). CONCLUSIONS: Children with asthma and anxiety or depression alone, or comorbid anxiety and depression, have higher rates of asthma-related ED use compared with those without either diagnosis. WHAT'S KNOWN ON THIS SUBJECT: Studies in adults have shown that anxiety and depression are associated with increased asthma-related emergency department use. However, there is limited literature that addresses this question for children with asthma. WHAT THIS STUDY ADDS: Children with asthma who had anxiety, depression, or comorbid anxiety and depression had higher emergency department use for asthma. Patients with comorbid anxiety and depression had an emergency department visit rate that was 2 times higher than that of patients without anxiety or depression.

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“…So zeigen Studien, dass in den USA ca. 7 % der in pädiatrischen Notaufnahmen behandelten Kinder und Jugendlichen, meist zwischen 12 und 17 Jahren, einen psychiatrischen Vorstellungsgrund hatten und die Anzahl der Kinder und Jugendlichen, die sich dort mit psychischen Problemen, vor allem Suizidalität und Aggressivität, vorstellten, sich zwischen 2000 und 2016 fast verdoppelt hatte [2,3]. Für Deutschland belegen Daten aus dem Jahr 2013, dass ca.…”

Section: Prävalenzunclassified

Psychische Krisen bei Kindern und Jugendlichen

Frey¹

2021

Nervenheilkunde

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ZUSAMMENFASSUNGPsychische Krisen im Kindes- und Jugendalter sind geprägt von altersspezifischen Vulnerabilitäten. Im Kindesalter stehen sie oft im Zusammenhang mit dem ausgeprägten Abhängigkeitsverhältnis gegenüber den Eltern und Situationen, in denen Eltern durch eine eigene oder eine psychische Erkrankung ihres Kindes in eine Überforderungssituation geraten. Im Jugendalter interagieren neurobiologische Veränderungen und herausfordernde Entwicklungsaufgaben, die eine krisenhafte Zuspitzung begünstigen können. Im Hinblick auf Kriseninterventionsstrategien für diese Altersgruppen stellen sich vor allem die Fragen, wie der Zugang zur Krisenintervention gelingt und welche Strategien es für die wichtigen sozialen Bezugssysteme Familie und Schule gibt?

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Trends in Visits and Costs for Mental Health Emergencies in a Pediatric Emergency Department, 2010–2016

Cited by 42 publications

References 34 publications

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

Depression, Anxiety, and Emergency Department Use for Asthma

Psychische Krisen bei Kindern und Jugendlichen

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