%0 Journal Article
%T Children＊s Mental Health Visits to the Emergency Department: Factors Affecting Wait Times and Length of Stay
%A Amanda S. Newton
%A Sachin Rathee
%A Simran Grewal
%A Nadia Dow
%A Rhonda J. Rosychuk
%J Emergency Medicine International
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/897904
%X Objective. This study explores the association of patient and emergency department (ED) mental health visit characteristics with wait time and length of stay (LOS). Methods. We examined data from 580 ED mental health visits made to two urban EDs by children aged ≒18 years from April 1, 2004, to March 31, 2006. Logistic regressions identified characteristics associated with wait time and LOS using hazard ratios (HR) with 95% confidence intervals (CIs). Results. Sex (male: , 95% 每1.84), ED type (pediatric ED: , 95% 每8.39), and triage level (Canadian Triage and Acuity Scale (CTAS) 2: , 95% 每5.85) were statistically significant predictors of wait time. ED type (pediatric ED: , 95% 每2.46), triage level (CTAS 5: , 95% 每3.48), number of consultations ( , 95% 每0.69), and number of laboratory investigations ( , 95% 每0.85) predicted LOS. Conclusions. Based on our results, quality improvement initiatives to reduce ED waits and LOS for pediatric mental health visits may consider monitoring triage processes and the availability, access, and/or time to receipt of specialty consultations. 1. Introduction In recent years, there has been considerable documentation of increases in visits by children to the emergency department (ED) for crisis mental health care [1每9]. Studies show that more parents are seeking care for their children in hospital EDs to treat acute emergencies [2, 4每6, 10, 11], request guidance for at-home child management [12], and gain access to health care resources [12]. The current health care system, however, does not meet the needs of families in the emergency care setting [3, 4, 13]. Many children do not receive comprehensive treatment for pediatric mental health visits and are discharged without adequate recommendations for follow-up care [14]. There is also increasing evidence for long waits for care and lengths of ED stay (LOS) [6, 8, 9, 15每19]. A stance among a number of studies is that wait times and LOS are important measures of treatment timeliness and patient safety [20每25]. A number of organizational and patient characteristics have been linked to wait time and LOS and serve to highlight the multifactorial nature of improving ED performance. Longer ED wait times for patients of all ages have been associated with a higher triage level (which denotes a lower level of urgency for the presenting complaint), an increased patient census (ED occupancy), urban-based EDs, day of arrival (Sunday, Monday, or Wednesday), and arrival by ※walk-in§ (versus ambulance) [26每31]. ED wait times have also been associated with race, ethnicity, and sex
%U http://www.hindawi.com/journals/emi/2014/897904/