The Dartmouth Institute for Health Policy and Clinical Practice and.
Department of Biomedical Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; and.
Pediatrics. 2020 Oct;146(4). doi: 10.1542/peds.2020-1174. Epub 2020 Sep 22.
The growing prevalence of pediatric mental and behavioral health disorders, coupled with scarce psychiatric resources, has resulted in a substantial increase in the number of youth waiting in emergency departments (EDs) and medical units for inpatient psychiatric care.
To characterize the prevalence of pediatric mental health boarding and identify associated patient and hospital factors.
Medline and PsycINFO.
All studies describing frequencies, durations, processes, outcomes, and/or risk factors associated with pediatric mental health boarding in youth ≤21 years of age.
Publications meeting inclusion criteria were charted by 2 authors and critically appraised for quality.
Eleven studies met inclusion criteria; 10 were retrospective cohort studies and 9 were conducted at single centers. All of the single-center studies were conducted at children's hospitals or pediatric EDs in urban or suburban settings. Study sample sizes ranged from 27 to 44 328. Among youth requiring inpatient psychiatric care, 23% to 58% experienced boarding and 26% to 49% boarded on inpatient medical units. Average boarding durations ranged from 5 to 41 hours in EDs and 2 to 3 days in inpatient units. Risk factors included younger age, suicidal or homicidal ideation, and presentation to a hospital during nonsummer months. Care processes and outcomes were infrequently described. When reported, provision of psychosocial services varied widely.
Boarding definitions were heterogeneous, study sample sizes were small, and rural regions and general hospitals were underrepresented.
Pediatric mental health boarding is prevalent and understudied. Additional research representing diverse hospital types and geographic regions is needed to inform clinical interventions and health care policy.
儿科精神和行为健康障碍的患病率不断上升，而精神科资源却相对匮乏，这导致等待在急诊部（ED）和医疗单位接受住院精神科治疗的青少年人数大幅增加。
描述儿科精神健康滞留的发生率，并确定相关的患者和医院因素。
Medline 和 PsycINFO。
所有描述与≤21 岁青少年的儿科精神健康滞留相关的频率、持续时间、过程、结果和/或风险因素的研究。
由 2 位作者对符合纳入标准的出版物进行图表绘制，并对其质量进行批判性评估。
11 项研究符合纳入标准；其中 10 项为回顾性队列研究，9 项研究在单一中心进行。所有单中心研究均在城市或郊区的儿童医院或儿科 ED 进行。研究样本量从 27 到 44328 不等。在需要住院精神科治疗的青少年中，23%至 58%经历过滞留，26%至 49%在住院内科滞留。ED 中的平均滞留时间从 5 到 41 小时不等，住院病房中的平均滞留时间为 2 到 3 天。风险因素包括年龄较小、自杀或杀人意念，以及在非夏季月份就诊。护理过程和结果很少被描述。当被报道时，心理社会服务的提供差异很大。
滞留的定义存在差异，研究样本量较小，农村地区和综合医院的代表性不足。
儿科精神健康滞留很普遍，但研究不足。需要更多代表不同医院类型和地理区域的研究来为临床干预和医疗保健政策提供信息。
