Journal article
Quality of Care for Youth Hospitalized for Suicidal Ideation and Self-Harm
Academic pediatrics, Vol.21(7), pp.1179-1186
09/2021
DOI: 10.1016/j.acap.2021.05.019
PMCID: PMC8448557
PMID: 34058402
Abstract
To examine performance on quality measures for pediatric inpatient suicidal ideation/self-harm care, and whether performance is associated with reutilization.
Retrospective observational 8 hospital study of patients [N = 1090] aged 5 to 17 years hospitalized for suicidal ideation/self-harm between 9/1/14 and 8/31/16. Two medical records-based quality measures assessing suicidal ideation/self-harm care were evaluated, one on counseling caregivers regarding restricting access to lethal means and the other on communication between inpatient and outpatient providers regarding the follow-up plan. Multivariable logistic regression assessed associations between quality measure scores and 1) hospital site, 2) patient demographics, and 3) 30-day emergency department return visits and inpatient readmissions.
Medical record documentation revealed that, depending on hospital site, 17% to 98% of caregivers received lethal means restriction counseling (mean 70%); inpatient-to-outpatient provider communication was documented in 0% to 51% of cases (mean 16%). The odds of documenting receipt of lethal means restriction counseling was higher for caregivers of female patients compared to caregivers of male patients (adjusted odds ratio [aOR] 1.51, 95% confidence interval [CI], 1.07–2.14). The odds of documenting inpatient-to-outpatient provider follow-up plan communication was lower for Black patients compared to White patients (aOR 0.45, 95% CI, 0.24–0.84). All-cause 30-day readmission was lower for patients with documented caregiver receipt of lethal means restriction counseling (aOR 0.48, 95% CI, 0.28–0.83).
This study revealed disparities and deficits in the quality of care received by youth with suicidal ideation/self-harm. Providing caregivers lethal means restriction counseling prior to discharge may help to prevent readmission.
Details
- Title: Subtitle
- Quality of Care for Youth Hospitalized for Suicidal Ideation and Self-Harm
- Creators
- Sarah K. Connell - University of WashingtonQ. Burkhart - RAND CorporationAnagha Tolpadi - RAND CorporationLayla Parast - RAND CorporationCourtney A. GidengilSteven Yung - Maimonides Medical CenterWilliam T. Basco - Medical University of South CarolinaDerek Williams - Vanderbilt University Medical CenterMaria T. Britto - Cincinnati Children's Hospital Medical CenterMark Brittan - Children's Hospital ColoradoKelly E. Wood - University of IowaNaomi Bardach - UCSF Benioff Children's HospitalJulie McGalliard - Seattle Children's Research InstituteRita Mangione-Smith - Kaiser Permanente Washington Health Research InstitutePediatric Research in Inpatient Settings (PRIS) Network
- Resource Type
- Journal article
- Publication Details
- Academic pediatrics, Vol.21(7), pp.1179-1186
- DOI
- 10.1016/j.acap.2021.05.019
- PMID
- 34058402
- PMCID
- PMC8448557
- NLM abbreviation
- Acad Pediatr
- ISSN
- 1876-2859
- eISSN
- 1876-2867
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1TR002537, U18HS025291; DOI: 10.13039/100000002, name: National Institutes of Health, award: UL1TR002537, U18HS025291; DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: UL1TR002537, U18HS025291; DOI: 10.13039/100005227, name: Centers for Medicare and Medicaid Services, award: UL1TR002537, U18HS025291
- Language
- English
- Date published
- 09/2021
- Academic Unit
- Stead Family Department of Pediatrics; Hospital Medicine
- Record Identifier
- 9984353932502771
Metrics
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