المؤلفون: Goldman-Mellor, Sidra, Phillips, Dwena, Brown, Paul, Gruenewald, Paul, Cerdá, Magdalena, Wiebe, Deborah

المصدر: Psychiatric Services. 71(2)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Pediatric, Behavioral and Social Science, Brain Disorders, Health Services, Clinical Research, Emergency Care, Mental Health, Mental health, Good Health and Well Being, Adolescent, Adolescent Behavior, California, Child, Emergency Service, Hospital, Female, Follow-Up Studies, Health Care Costs, Hospitalization, Humans, Male, Regression Analysis, Retrospective Studies, Self-Injurious Behavior, Young Adult, Adolescents/adolescence, Suicide and self-destructive behavior, Public Health and Health Services, Psychiatry, Clinical sciences, Health services and systems

الوصف: ObjectiveSelf-harm rates among U.S. adolescents have risen substantially. Health and social outcomes among contemporary self-harming youths are infrequently tracked and poorly understood. This study investigated long-term health service utilization (emergency department [ED] visits and inpatient admissions) and inpatient costs among a recent cohort of adolescents with deliberate self-harm.MethodsThis retrospective cohort study used statewide, all-payer, longitudinally linked discharge data from California. All residents ages 10-19 presenting to EDs in 2010 with deliberate self-harm (N=5,396) were compared with two control groups: a random sample of adolescent ED patients with other complaints, matched on sex, age, residential zip code, and month of index visit (general control patients, N=14,921), and matched ED patients with psychiatric complaints but no self-harm (psychiatric control patients, N=15,835). Outcomes included 5-year rates of ED visits, inpatient admissions, and inpatient costs, overall and for psychiatric and nonpsychiatric complaints separately.ResultsSelf-harm patients' ED use, inpatient admissions, and inpatient costs were significantly higher than those of general control patients (by 39%, 81%, and 21%, respectively), when the analysis controlled for confounding demographic and utilization characteristics. Associations mostly persisted, although smaller in magnitude, in comparisons between self-harm and psychiatric control patients. Psychiatric and nonpsychiatric complaints contributed to self-harming adolescents' excess health service utilization and costs.ConclusionsDeliberate self-harm among adolescents was found to be associated with long-lasting and costly patterns of health service utilization, often but not exclusively for psychiatric complaints. Future research should investigate the pathways underlying these associations and incorporate service utilization as a key patient outcome.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3b33g9tpTest

المؤلفون: Sidra Goldman-Mellor, Paul Brown, Dwena Phillips, Magdalena Cerdá, Paul Gruenewald, Deborah J. Wiebe

المصدر: Psychiatr Serv
Psychiatric services (Washington, D.C.), vol 71, iss 2

مصطلحات موضوعية: Male, medicine.medical_specialty, Adolescent, Emergency Care, California, Article, Adolescents/adolescence, Hospital, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Clinical Research, Behavioral and Social Science, medicine, Humans, 030212 general & internal medicine, Child, Retrospective Studies, Pediatric, Psychiatry, Emergency Service, business.industry, Five year follow up, Emergency department, Health Care Costs, Health Services, Brain Disorders, 030227 psychiatry, Hospitalization, Psychiatry and Mental health, Mental Health, Good Health and Well Being, Adolescent Behavior, Family medicine, Suicide and self-destructive behavior, Deliberate self-harm, Public Health and Health Services, Regression Analysis, Female, business, Emergency Service, Hospital, Self-Injurious Behavior, Follow-Up Studies

الوصف: OBJECTIVE: Adolescent self-harm rates have risen substantially in the U.S., yet health and social outcomes among contemporary self-harming youths are infrequently tracked and remain poorly understood. This study investigated long-term health service utilization (emergency department [ED] visits and inpatient admissions) and inpatient costs among a recent cohort of adolescent deliberate self-harm patients. METHODS: This retrospective cohort study used statewide, all-payer, longitudinally-linked patient discharge data from California, USA. All CA residents aged 10–19 years presenting to EDs in 2010 with deliberate self-harm (n=5,396) were compared with two control groups: A random sample of adolescent patients with other complaints, matched on sex, age, residential ZIP code, and month of index visit (general control patients; n=14,921), and matched patients with psychiatric complaints but no self-harm (psychiatric controls; n=15,835). Study outcomes included five-year rates of subsequent ED visits, inpatient admissions, and inpatient costs, both overall and for psychiatric and non-psychiatric complaints separately. RESULTS: Self-harm patients’ rates of ED utilization, inpatient admissions, and inpatient costs were significantly higher than those of general control patients (by 39%, 81%, and 21%, respectively), controlling for confounding demographic and utilization characteristics. Associations mostly persisted, though smaller in magnitude, in comparisons with psychiatric control patients. Both psychiatric and non-psychiatric complaints contributed to self-harming adolescents’ excess health service utilization and costs. CONCLUSION: Adolescent deliberate self-harm is associated with long-lasting and costly patterns of health service utilization, often but not exclusively for psychiatric complaints. Future research should investigate the pathways underlying these associations, and incorporate service utilization as a key patient outcome.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ecd4cf803d0b978c1788595e98a26334Test
https://pubmed.ncbi.nlm.nih.gov/31575352Test