Table.
Characteristics of Emergency Department Visits by Children for Mental Health Conditions, Before and During the COVID-19 Pandemic
| ED Visit Characteristic | Total ED Visits (N = 8127)* | ED Visits Prepandemic, Mar 2018–Feb 2020 (N = 5278)* | ED Visits During the Pandemic Mar 2020–Feb 2021, (N = 2849)* | Pandemic–Prepandemic Risk Difference (95% CI) |
|---|---|---|---|---|
| Sex | ||||
| Female | 4754 (58.5%) | 3048 (57.7%) | 1706 (59.9%) | 2.15 (−0.09, 4.39) |
| Male | 3372 (41.5%) | 2230 (42.3%) | 1142 (40.1%) | −2.15 (−4.39, 0.09) |
| Age Group | ||||
| 5-8 years | 399 (4.9%) | 255 (4.8%) | 144 (5.1%) | 0.22 (−0.77, 1.21) |
| 9-12 years | 1577 (19.4%) | 1027 (19.5%) | 550 (19.3%) | −0.15 (−1.95, 1.65) |
| 13-15 years | 3445 (42.4%) | 2209 (41.9%) | 1236 (43.4%) | 1.53 (−0.72, 3.79) |
| 16-17 years | 2706 (33.3%) | 1787 (33.9%) | 919 (32.3%) | −1.60 (−3.74, 0.54) |
| Race and Ethnicity | ||||
| Asian, Not-Hispanic/Latino | 258 (3.2%) | 176 (3.3%) | 82 (2.9%) | −0.46 (−1.24, 0.33) |
| Black, Not-Hispanic/Latino | 1069 (13.2%) | 716 (13.6%) | 353 (12.4%) | −1.18 (−2.7, 0.35) |
| White, Hispanic/Latino | 883 (10.9%) | 621 (11.8%) | 262 (9.2%) | −2.57 (−3.94, −1.20) |
| White, Not-Hispanic/Latino | 4413 (54.3%) | 2834 (53.7%) | 1579 (55.4%) | 1.73 (−0.54, 4.0) |
| Other Race, Hispanic/Latino | 1138 (14.0%) | 720 (13.6%) | 418 (14.7%) | 1.03 (−0.57, 2.63) |
| Other /Unknown | 366 (4.5%) | 211 (4.0%) | 155 (5.4%) | 1.44 (0.46, 2.43) |
| Preferred Language | ||||
| English | 7544 (92.8%) | 4898 (92.8%) | 2646 (92.9%) | 0.07 (−1.10, 1.25) |
| Spanish | 535 (6.6%) | 349 (6.6%) | 186 (6.5%) | −0.08 (−1.21, 1.04) |
| Other | 48 (0.6%) | 31 (0.6%) | 17 (0.6%) | 0.01 (−0.34, 0.36) |
| Insurance | ||||
| Private | 4538 (55.8%) | 2976 (56.4%) | 1562 (54.8%) | −1.56 (−3.82, 0.71) |
| Public | 3,488 (42.9%) | 2238 (42.4%) | 1250 (43.9%) | 1.47 (−0.79, 3.73) |
| Other/Uninsured | 101 (1.2%) | 64 (1.2%) | 37 (1.3%) | 0.09 (−0.42, 0.60) |
| Child Opportunity Index | ||||
| Very Low | 824 (10.5%) | 574 (11.3%) | 250 (9.0%) | −2.25 (−3.63, −0.88) |
| Low | 1258 (16.0%) | 834 (16.4%) | 424 (15.3%) | −1.08 (−2.76, 0.60) |
| Moderate | 1584 (20.1%) | 960 (18.8%) | 624 (22.5%) | 3.66 (1.77, 5.54) |
| High | 1978 (25.1%) | 1221 (24.0%) | 757 (27.3%) | 3.33 (1.30, 5.36) |
| Very High | 2226 (28.3%) | 1507 (29.6%) | 719 (25.9%) | −3.65 (−5.71, −1.60) |
| Mental Health Group | ||||
| Accidental or Undetermined Poisoning | 32 (0.4%) | 17 (0.3%) | 15 (0.5%) | 0.20 (−0.10, 0.51) |
| Anxiety Disorders | 1228 (15.1%) | 856 (16.2%) | 372 (13.1%) | −3.16 (−4.75, −1.57) |
| Bipolar and Related Disorders | 120 (1.5%) | 72 (1.4%) | 48 (1.7%) | 0.32 (−0.25, 0.89) |
| Depressive Disorders | 2563 (31.5%) | 1734 (32.9%) | 829 (29.1%) | −3.76 (−5.85, −1.66) |
| Disruptive, Impulse Control and Conduct Disorders | 451 (5.5%) | 257 (4.9%) | 194 (6.8%) | 1.94 (0.85, 3.03) |
| Mental Health Symptom | 592 (7.3%) | 373 (7.1%) | 219 (7.7%) | 0.62 (−0.58, 1.82) |
| Miscellaneous | 207 (2.5%) | 140 (2.7%) | 67 (2.4%) | −0.30 (−1.01, 0.40) |
| Schizophrenia Spectrum and Other Psychotic Disorders | 133 (1.6%) | 92 (1.7%) | 41 (1.4%) | −0.30 (−0.87, 0.26) |
| Substance-Related and Addictive Disorders | 500 (6.2%) | 339 (6.4%) | 161 (5.7%) | −0.77 (−1.85, 0.30) |
| Suicide or Self-Injury | 1849 (22.8%) | 1077 (20.4%) | 772 (27.1%) | 6.69 (4.73, 8.65) |
| Trauma and Stressor-Related Disorders | 346 (4.3%) | 236 (4.5%) | 110 (3.9%) | −0.61 (−1.51, 0.29) |
| Other Disorders (Dissociative, Obsessive-Compulsive, Somatic, Sleep-Wake) | 106 (1.3%) | 85 (1.6%) | 21 (0.7%) | −0.87 (−1.34, −0.41) |
| Prior Mental Health Diagnosis | ||||
| No | 6197 (76.3%) | 4067 (77.1%) | 2130 (74.8%) | −2.29 (−4.25, −0.34) |
| Yes | 1930 (23.7%) | 1211 (22.9%) | 719 (25.2%) | 2.29 (0.34, 4.25) |
| Behavioral Health Consult | ||||
| No | 3337 (41.1%) | 2236 (42.4%) | 1101 (38.6%) | −3.72 (−5.95, −1.49) |
| Yes | 4790 (58.9%) | 3042 (57.6%) | 1748 (61.4%) | 3.72 (1.49, 5.95) |
| Hospital Type | ||||
| Community Hospital | 5073 (62.4%) | 3193 (60.5%) | 1880 (66.0%) | 5.49 (3.31, 7.67) |
| Academic Medical | 132 (1.6%) | 105 (2.0%) | 27 (0.9%) | −1.04 (−1.56, −0.52) |
| Children's Hospital | 2922 (36.0%) | 1980 (37.5%) | 942 (33.1%) | −4.45 (−6.62, −2.28) |
| Disposition from ED | ||||
| Home | 4568 (57.8%) | 3061 (59.8%) | 1507 (54.0%) | −5.81 (−8.10, −3.53) |
| Psychiatric Admission | 2843 (35.9%) | 1813 (35.4%) | 1030 (36.9%) | 1.48 (−0.74, 3.70) |
| Medical Admission | 490 (6.2%) | 239 (4.7%) | 251 (9.0%) | 4.32 (3.11, 5.53) |
| General Medical Unit | 388 (4.8%) | 178 (3.4%) | 210 (7.4%) | 4.05 (2.95, 5.15) |
| Critical Care/ Intermediate Care Unit | 102 (1.3%) | 61 (1.2%) | 41 (1.4%) | 0.28 (−0.26, 0.81) |
| Other† | 8 (0.1%) | 5 (0.1%) | 3 (0.1%) | 0.01 (−0.14, 0.16) |
⁎
n (%); proportions estimated based on non-missing data.
†
Left Without Being Seen, Against Medical Advice, Deceased.