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Association Between Insurance and the Transfer of Children With Mental Health Emergencies

Kissee, Jamie L ; Huang, Yunru ; Dayal, Parul ; Yellowlees, Peter ; Sigal, Ilana ; Marcin, James P

Pediatric emergency care, 2021-12, Vol.37 (12), p.e1026-e1032 [Periódico revisado por pares]

United States: Copyright Wolters Kluwer Health, Inc. All rights reserved

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  • Título:
    Association Between Insurance and the Transfer of Children With Mental Health Emergencies
  • Autor: Kissee, Jamie L ; Huang, Yunru ; Dayal, Parul ; Yellowlees, Peter ; Sigal, Ilana ; Marcin, James P
  • Assuntos: Child ; Cross-Sectional Studies ; Emergencies ; Emergency Service, Hospital ; Humans ; Insurance Coverage ; Insurance, Health ; Mental Health ; Patient Transfer ; Retrospective Studies ; United States
  • É parte de: Pediatric emergency care, 2021-12, Vol.37 (12), p.e1026-e1032
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: OBJECTIVESThis study sought to investigate the association between a patientʼs insurance coverage and a hospitalʼs decision to admit or transfer pediatric patients presenting to the emergency department (ED) with a mental health disorder. METHODSThis is a cross-sectional study of pediatric mental health ED admission and transfer events using the Healthcare Cost and Utilization Project 2014 Nationwide Emergency Department Sample. Children presenting to an ED with a primary mental health disorder who were either admitted locally or transferred to another hospital were included. Multivariable logistic regression models were used to adjust for confounders. RESULTSNine thousand eighty-one acute mental health ED events among children were included in the analyses. The odds of transfer relative to admission were higher for children without insurance (odds ratio, 3.30; 95% confidence interval, 1.73–6.31) compared with patients with private insurance. The odds of transfer were similar for children with Medicaid compared with children with private insurance (odds ratio, 1.23; 95% confidence interval, 0.80–1.88). Transfer rates also varied across mental health diagnostic categories. Patients without insurance had higher odds of transfer compared with those with private insurance when they presented with depressive disorder, bipolar disorder, attention-deficit/conduct disorders, and schizophrenia. CONCLUSIONSChildren presenting to an ED with a mental health emergency who do not have insurance are more likely to be transferred to another hospital than to be admitted and treated locally compared with those with private insurance. Future studies are needed to determine factors that may protect patients without insurance from disparities in access to care.
  • Editor: United States: Copyright Wolters Kluwer Health, Inc. All rights reserved
  • Idioma: Inglês
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