Association of Race/Ethnicity and Social Determinants with Rehospitalization for Mental Health Conditions at Acute Care Children's Hospitals.

Autor: Carroll AR; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN. Electronic address: alison.carroll@vumc.org., Hall M; Children's Hospital Association, Lenexa, KS., Brown CM; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Johnson DP; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Antoon JW; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Kreth H; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Ngo ML; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Browning W; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Neeley M; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Herndon A; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Chokshi SB; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Plemmons G; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Johnson J; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Hart SR; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Williams DJ; Monroe Carell Jr Children's Hospital at Vanderbilt, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2022 Jan; Vol. 240, pp. 228-234.e1. Date of Electronic Publication: 2021 Sep 01.
DOI: 10.1016/j.jpeds.2021.08.078
Abstrakt: Objective: To evaluate associations of race/ethnicity and social determinants with 90-day rehospitalization for mental health conditions to acute care nonpsychiatric children's hospitals.
Study Design: We conducted a retrospective cohort analysis of mental health hospitalizations for children aged 5-18 years from 2016 to 2018 at 32 freestanding US children's hospitals using the Children's Hospital Association's Pediatric Health Information System database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Risk factors for rehospitalization were modeled using mixed-effects multivariable logistic regression.
Results: Among 23 556 index hospitalizations, there were 1382 mental health rehospitalizations (5.9%) within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children (aOR 1.26, 95% CI 1.08-1.48). Those with government insurance were 18% more likely to be rehospitalized than those with private insurance (aOR 1.18, 95% CI 1.04-1.34). In contrast, those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location (suburban: aOR 0.78, 95% CI 0.63-0.97).
Conclusions: Non-Hispanic Black children and those with public insurance were at greatest risk for 90-day rehospitalization, and risk was lower in those residing in suburban locations. Future work should focus on upstream interventions that will best attenuate social disparities to promote equity in pediatric mental healthcare.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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