- 作者：David C. Sheridan ; MD&lowast ; ; ; John Sheridan ; LCSW ; MSW&dagger ; ; Kyle P. Johnson ; MD&Dagger ; ; Amber Laurie ; MS&lowast ; ; § ; ; Allyson Knapper ; BS&lowast ; ; Rongwei Fu ; PhD&lowast ; ; § ; ; Shannon Appy ; MD ; MPH&lowast ; ; Matthew L. Hansen ; MD ; MCR&lowast ;
- 关键词：child ; mental ; emergency department ; acute
- 刊名：Journal of Emergency Medicine
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：50
- 期：3
- 页码：e121-e128
- 全文大小：250 K
Objective
The objective of this study was to evaluate the effect of a new pediatric mental health liaison program with the hypothesis that this model reduces length of stay (LOS) and hospitalization rates among pediatric mental health patients.
Methods
This was a pre- and postintervention retrospective study of the year prior to (June 2012–June 2013) and the year after (October 2013–October 2014) implementation of a new PED psychiatric team. All patients aged 1–18 years with a mental health International Classification of Diseases-9th Revision code were included. Patients who did not receive a Psychiatry consult in the PED were excluded.
Results
There were 83 encounters in the year prior to and 129 encounters in the year after the implementation of the liaison program. There was an increase in the suicidality of mental health patients during this time. There was a significant decrease in mean PED LOS of 27% (95% confidence interval [CI] 0–46%; p = 0.05) from pre- to postintervention period. The decrease in the proportion of patients admitted/transferred to an inpatient psychiatric facility in the postintervention year was statistically significant (odds ratio 0.35; 95% CI 0.17–0.71; p < 0.01).
Conclusions
The use of a dedicated child psychiatrist and mental health social worker to the PED results in significantly decreased LOS and need for admission without any change in return visit rate. Larger, multicenter studies are needed to confirm these findings.