Although patients with a primary mental health condition make up about 10 percent of pediatric hospitalizations, there is little research exploring care quality for these patients in hospital settings, prompting researchers to develop measures to assess it in emergency departments and inpatient settings.
An evidence-based set of pediatric mental healthcare quality measures were tested in two community hospitals and three children's hospitals. Eligible patients ranged from ages 5 to 19 and were diagnosed with psychosis, suicidality or substance use between January 2012 and December 2013. Eight hundred and seventeen records were abstracted with primary diagnoses of suicidality (446), psychosis (321) and substance use (50).
Four insights from the research:
1. Among patients with suicidality, male patients and African-American patients were less likely to have documentation from caregivers verifying they provided counseling on keeping firearms or other potentially lethal devices away.
2. Among admitted suicidal patients, 27 percent had documentation of communication with an outside provider, with variation across hospitals.
3. The study found low overall performance on screening for comorbid substance abuse in ED patients diagnosed with psychosis.
4. "These new pediatric mental health care quality measures were used to identify sex and race disparities and substantial hospital variation," the researchers concluded. "These measures may be useful for assessing and improving hospital-based pediatric mental healthcare quality."