Trends for Electroconvulsive Therapy Utilization in Children and Adolescents in the United States From 2002 to 2017
| Autor: | Chintan Trivedi, Fatima Motiwala, Zeeshan Mansuri, Pranita Mainali, Shailesh Jain |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Neuroscience (miscellaneous) behavioral disciplines and activities White race 03 medical and health sciences 0302 clinical medicine Electroconvulsive therapy Internal medicine mental disorders medicine Humans Private insurance Child Electroconvulsive Therapy African american Inpatients business.industry Length of Stay Hospitals United States Multilevel regression 030227 psychiatry Psychiatry and Mental health Coding system Baseline characteristics business Hospital stay 030217 neurology & neurosurgery |
| Zdroj: | The Journal of ECT. 37:100-106 |
| ISSN: | 1533-4112 1095-0680 |
| DOI: | 10.1097/yct.0000000000000750 |
| Popis: | OBJECTIVES Electroconvulsive therapy (ECT) is controversial in children and adolescents (C/A). The primary objective of this study was to evaluate baseline characteristics of C/A in the utilization of ECT compared with the non-ECT group with the same primary indication. The secondary objective was to assess the trends in ECT utilization over 16 years and explore the predictors of length of stay. METHODS Using the Nationwide Inpatient Sample database from the years 2002 to 2017, we identified patients (age ≤18 years) undergoing ECT in the United States using International Classification of Diseases, Ninth Revision and Tenth Revision, Clinical Modification/Procedure Coding System codes and compared with non-ECT C/A patients with the same primary diagnosis. Baseline clinical characteristics were assessed using descriptive analysis methods. Multilevel regression analysis and trend analysis were performed. RESULTS Children and adolescent patients (n = 159,158) receiving (ECT: n = 1870) were more likely to be men (43.3% vs 36.7%) and of White race (58% vs 49%) (P < 0.001). The hospital stay was longer (19 days vs 6 days, P < 0.001) for the ECT group than controls. ECT receiving C/A patients were more likely to have private insurance (72% vs 42%, P < 0.001). African American patients undergoing ECT treatment increased in number over the course of years (2002 to 2017), whereas the privately insured C/A patients receiving ECT decreased over the same period (P < 0.001). There was an upward trend in ECT utilization for small bed size hospitals (P < 0.001). Length of stay for C/A receiving ECT was longer for males (P < 0.001) and patients with nonprivate insurance (p: 0.003). CONCLUSIONS Electroconvulsive therapy is not optimally used in C/A; therefore, formulated treatment guidelines are required. |
| Databáze: | OpenAIRE |
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