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Follow-up after hospitalization for mental illness is a measure of quality care, but how many children and teenagers are getting timely follow-up? A new report investigates.
A quality measure of the Child Core Set is whether children and teenagers who have been hospitalized because of a mental illness also receive timely follow-up care after they leave the hospital. A report in Pediatrics examines the impact of the quality measure.1
Investigators used the Truven MarketScan Medicaid Database 2015-2016 to identify hospitalizations in children and adolescents aged 6 to 17 years that included a primary diagnosis of depression, bipolar disorder, psychosis, or anxiety.
There were 22,844 hospitalizations with 62% having 7-day follow-up and 82.3% having 30-day follow-up. Acute care following release was common with 22.4% either revisiting the emergency department or requiring hospital admission within 30 days and 54.8% requiring either within 6 months. A decreased likelihood of follow-up was associated with fee-for-service insurance, having no comorbidities, suicide attempt, discharge from a medical or surgical unit, and non-Hispanic or non-Latino black race and/or ethnicity. Appropriately timed outpatient follow-up was linked to increased subsequent acute care use.
The researchers concluded that many patients were receiving timely follow-up care, but variations still suggest that improvements can be made. The increased risk of subsequent acute care highlights the complexity of the cases and indicates that follow-up visits could be a chance to intervene.
1. Bardach NS, Doupnik SK, Rodean J, et al. ED visits and readmissions after follow-up for mental health hospitalization. Pediatrics. 2020;145(6) e20192872. doi: 10.1542/peds.2019-2872