More than 10% of pediatric visits to the emergency department for mental health conditions result in ED boarding, according to research published Aug. 15 in JAMA.
Boarding, or the practice of holding patients in the ED while waiting for an appropriate inpatient bed, is a growing issue as it can lead to care delays, clinical deterioration and increased costs.
To quantify the issue, researchers from Portland-based Oregon Health & Sciences University and Cambridge (Mass.) Health Alliance analyzed more than 255,000 ED visits for mental health conditions among Medicaid-enrolled youths.
The study defined ED boarding as a visit spanning three to seven days.
Among the thousands of ED visits for mental health-related issues, 11.9% of them resulted in children and teens waiting more than three days for a needed inpatient bed.
Iowa had the highest rate of mental health ED visits resulting in boarding at 27.3%. Other states with high rates were Montana, North Carolina, Maine and Florida, which all had boarding from more than 1 in 5 of these visits. Arkansas had the lowest rate, at 2.7%.
The most common mental health conditions resulting in boarding were depressive disorders and suicidal thoughts and attempts, the study found.
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