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Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

机译：小儿精神病学摄入反应中心患者再次住院和住院治疗的危险因素

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Background The study sought to explore the characteristics, risk factors for inpatient recommendation, and risk factors for revisits to a pediatric psychiatric intake response center (PIRC). There are three research questions: 1. What is the general profile of pediatric patients who present at the PIRC? 2. What are the risk factors for patients who repeatedly visit the PIRC? 3. What are the risk factors for PIRC patients who are recommended to inpatient care? Methods The study utilized a retrospective medical chart review of a random sample (n?=?260). A PIRC profile was created using frequency and prevalence calculations, in addition to a survival analysis of patients who return to the PIRC in order to determine how long it takes for PIRC patients to return to the PIRC. Factors that contribute to increased odds of returning to PIRC and being recommended for inpatient treatment were calculated using two logistic regression analyses. Results The average pediatric PIRC patient is about 13 years old, Caucasian, with Medicaid and comes from a divorced or single parent household. About 43% of patients presented at PIRC for suicidal thoughts, ideation, intentions or actions. At least 63% of patients have a history of victimization. The average time to return to PIRC is about 90 days. Patients with a history of victimization, suicidal behavior, learning problems, problems with peers, and a history of violence were at an increased odds of returning to the PIRC. Those patients who were previously admitted to inpatient care and had a family history of mental health issues were at increased odds of being recommended to inpatient treatment. Conclusions This sample presents with a multitude of issues that contribute to increased odds of revisits to PIRC and inpatient recommendation. These issues seem to come from multiple levels of influence. Future research should expand to similar treatment facilities and use a prospective design to confirm risk factors. Treatment for pediatric psychiatric patients may focus on multiple factors that influence patients’ mental health.
机译：背景研究旨在探讨特征，住院推荐的危险因素以及再次进入儿科精神病学摄入反应中心（PIRC）的危险因素。存在三个研究问题：1.参加PIRC的儿科患者的总体情况如何？ 2.反复访问PIRC的患者有哪些危险因素？ 3.被推荐住院治疗的PIRC患者有哪些危险因素？方法该研究采用回顾性医学图表回顾法，随机抽样（n = 260）。除了对返回PIRC的患者进行生存分析以确定PIRC患者返回PIRC需要多长时间外，还使用频率和患病率计算创建了PIRC配置文件。使用两个逻辑回归分析计算了导致重返PIRC可能性增加并被推荐用于住院治疗的因素。结果小儿PIRC患者的平均年龄约为13岁，高加索人，有医疗补助，来自离异或单亲家庭。大约43％的患者因自杀的想法，想法，意图或行为而出现在PIRC上。至少63％的患者有受害史。重返PIRC的平均时间约为90天。具有受害史，自杀行为，学习问题，同伴问题以及暴力史的患者返回PIRC的可能性增加。那些以前曾接受过住院治疗并且有精神健康史的患者被推荐住院治疗的几率增加。结论本样本提出了许多问题，这些问题导致再次访问PIRC和住院建议的几率增加。这些问题似乎来自多个层次的影响。未来的研究应扩大到类似的治疗设施，并使用前瞻性设计来确定危险因素。儿科精神病患者的治疗可能侧重于影响患者心理健康的多种因素。

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