Evaluating the pediatric mental health care continuum at an American health system
Objective: To describe trends in the pediatric mental health care continuum and identify potential gaps in care coordination. Methods: We used electronic medical record data from October 2016 to September 2019 to characterize the prevalence of mental health issues in the pediatric population at a la...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-06-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121231181939 |
| _version_ | 1797798216301805568 |
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| author | Joshua Thariath Rama A. Salhi Neil Kamdar Kristian Seiler Margaret Greenwood-Ericksen Wilson Nham Kaitlyn Simpson Timothy Peterson Mahshid Abir |
| author_facet | Joshua Thariath Rama A. Salhi Neil Kamdar Kristian Seiler Margaret Greenwood-Ericksen Wilson Nham Kaitlyn Simpson Timothy Peterson Mahshid Abir |
| author_sort | Joshua Thariath |
| collection | DOAJ |
| description | Objective: To describe trends in the pediatric mental health care continuum and identify potential gaps in care coordination. Methods: We used electronic medical record data from October 2016 to September 2019 to characterize the prevalence of mental health issues in the pediatric population at a large American health system. This was a single institution case study. From the electronic medical record data, primary mental health discharge and readmission diagnoses were identified using International Classification of Diseases (ICD-9-CM, ICD-10-CM) codes. The electronic medical record was queried for mental health-specific diagnoses as defined by International Classification of Diseases classification, analysis of which was facilitated by the fact that only 176 mental health codes were billed for. Additionally, prevalence of care navigation encounters was assessed through electronic medical record query, as care navigation encounters are specifically coded. These encounter data was then segmented by care delivery setting. Results: Major depressive disorder and other mood disorders comprised 49.6% and 89.4% of diagnoses in the emergency department and inpatient settings respectively compared to 9.0% of ambulatory care diagnoses and were among top reasons for readmission. Additionally, only 1% of all ambulatory care encounters had a care navigation component, whereas 86% of care navigation encounters were for mental health-associated reasons. Conclusions: Major depressive disorder and other mood disorders were more common diagnoses in the emergency department and inpatient settings, which could signal gaps in care coordination. Bridging potential gaps in care coordination could reduce emergency department and inpatient utilization through increasing ambulatory care navigation resources, improving training, and restructuring financial incentives to facilitate ambulatory care diagnosis and management of major depressive disorder and mood disorders. Furthermore, health systems can use our descriptive analytic approach to serve as a reasonable measure of the current state of pediatric mental health care in their own patient population. |
| first_indexed | 2024-03-13T04:00:08Z |
| format | Article |
| id | doaj.art-93b121ea6885491a939688d1248035c0 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-03-13T04:00:08Z |
| publishDate | 2023-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-93b121ea6885491a939688d1248035c02023-06-21T16:04:50ZengSAGE PublishingSAGE Open Medicine2050-31212023-06-011110.1177/20503121231181939Evaluating the pediatric mental health care continuum at an American health systemJoshua Thariath0Rama A. Salhi1Neil Kamdar2Kristian Seiler3Margaret Greenwood-Ericksen4Wilson Nham5Kaitlyn Simpson6Timothy Peterson7Mahshid Abir8Acute Care Research Unit, University of Michigan, Ann Arbor, USADepartment of Emergency Medicine, University of Michigan, Ann Arbor, USAInstitute for Healthcare Policy and Innovation, Ann Arbor, USAInstitute for Healthcare Policy and Innovation, Ann Arbor, USADepartment of Emergency Medicine, University of New Mexico, Albuquerque, USADepartment of Emergency Medicine, University of Michigan, Ann Arbor, USAAcute Care Research Unit, University of Michigan, Ann Arbor, USAHenry Ford Health, Detroit, USARAND Corporation, Santa Monica, CA, USAObjective: To describe trends in the pediatric mental health care continuum and identify potential gaps in care coordination. Methods: We used electronic medical record data from October 2016 to September 2019 to characterize the prevalence of mental health issues in the pediatric population at a large American health system. This was a single institution case study. From the electronic medical record data, primary mental health discharge and readmission diagnoses were identified using International Classification of Diseases (ICD-9-CM, ICD-10-CM) codes. The electronic medical record was queried for mental health-specific diagnoses as defined by International Classification of Diseases classification, analysis of which was facilitated by the fact that only 176 mental health codes were billed for. Additionally, prevalence of care navigation encounters was assessed through electronic medical record query, as care navigation encounters are specifically coded. These encounter data was then segmented by care delivery setting. Results: Major depressive disorder and other mood disorders comprised 49.6% and 89.4% of diagnoses in the emergency department and inpatient settings respectively compared to 9.0% of ambulatory care diagnoses and were among top reasons for readmission. Additionally, only 1% of all ambulatory care encounters had a care navigation component, whereas 86% of care navigation encounters were for mental health-associated reasons. Conclusions: Major depressive disorder and other mood disorders were more common diagnoses in the emergency department and inpatient settings, which could signal gaps in care coordination. Bridging potential gaps in care coordination could reduce emergency department and inpatient utilization through increasing ambulatory care navigation resources, improving training, and restructuring financial incentives to facilitate ambulatory care diagnosis and management of major depressive disorder and mood disorders. Furthermore, health systems can use our descriptive analytic approach to serve as a reasonable measure of the current state of pediatric mental health care in their own patient population.https://doi.org/10.1177/20503121231181939 |
| spellingShingle | Joshua Thariath Rama A. Salhi Neil Kamdar Kristian Seiler Margaret Greenwood-Ericksen Wilson Nham Kaitlyn Simpson Timothy Peterson Mahshid Abir Evaluating the pediatric mental health care continuum at an American health system SAGE Open Medicine |
| title | Evaluating the pediatric mental health care continuum at an American health system |
| title_full | Evaluating the pediatric mental health care continuum at an American health system |
| title_fullStr | Evaluating the pediatric mental health care continuum at an American health system |
| title_full_unstemmed | Evaluating the pediatric mental health care continuum at an American health system |
| title_short | Evaluating the pediatric mental health care continuum at an American health system |
| title_sort | evaluating the pediatric mental health care continuum at an american health system |
| url | https://doi.org/10.1177/20503121231181939 |
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