Abstract
Objective
To examine national trends in hospital utilization, costs, and expenditures for children
with mental health conditions.
Methods
The analyses of children aged 1 to 17 are based on AHRQ's 2006 and 2011 Healthcare
Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) and Nationwide
Emergency Department Sample (NEDS) databases, and on AHRQ's pooled 2006 to 2011 Medical
Expenditure Panel Survey (MEPS). All estimates are nationally representative, and
standard errors account for the complex survey designs.
Results
Although overall all-cause children's hospitalizations did not increase between 2006
and 2011, hospitalizations for all listed mental health conditions increased by nearly
50% among children aged 10 to 14 years, and by 21% for emergency department (ED) visits.
Behavioral disorders experienced a shift in underlying patterns between 2006 and 2011:
inpatient stays for alcohol-related disorders declined by 44%, but ED visits increased
by 34% for substance-related disorders and by 71% for impulse control disorders. Inpatient
visits for suicide, suicidal ideation, and self-injury increased by 104% for children
ages 1 to 17 years, and by 151% for children ages 10 to 14 years during this period.
A total of $11.6 billion was spent on hospital visits for mental health during this
period. Medicaid covered half of the inpatient visits, but with 50% to 30% longer
length of stays in 2006 and 2011, respectively, than private payers. Medicaid's overall
share of the ED visits increased from 45% in 2006 to 53% in 2011.
Conclusions
These alarming trends highlight the renewed need for research on mental health care
for children. This study also provides a baseline for evaluating the impact of the
Affordable Care Act and the mental health parity legislation on mental health utilization
and expenditures for children.
Keywords
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Article Info
Publication History
Published online: November 13, 2014
Accepted:
July 31,
2014
Received:
April 15,
2014
Footnotes
The authors declare that they have no conflict of interest. The views expressed in this article are those of the authors and do not necessarily represent those of the Agency for Healthcare Research and Quality (AHRQ) or the Department of Health and Human Services (HHS).
Identification
Copyright
Published by Elsevier Inc.
