Table 2. Factors Associated With Mental Health Emergency Department Revisits Within 6 Months for Patients Discharged From the Index Emergency Department Visit.
| Characteristic | Patients with revisits (n = 14 566 [11.5%]), No. (%) | HR (95% CI) |
|---|---|---|
| Predisposing factors | ||
| Age group, y | ||
| 3-7 | 1281 (8.8) | 1 [Reference] |
| 8-12 | 5277 (36.2) | 1.23 (1.16-1.31) |
| 13-17 | 8008 (55.0) | 1.13 (1.06-1.20) |
| Sex | ||
| Female | 7516 (51.6) | 1 [Reference] |
| Male | 7050 (48.4) | 0.94 (0.91-0.98) |
| Race and ethnicity | ||
| Asian American | 234 (1.6) | 0.93 (0.81-1.06) |
| Hispanic | 2302 (15.8) | 0.83 (0.78-0.87) |
| Non-Hispanic Black | 3548 (24.4) | 0.97 (0.93-1.02) |
| Non-Hispanic White | 7298 (50.1) | 1 [Reference] |
| Othera | 1184 (8.1) | 0.90 (0.84-0.96) |
| Enabling factors | ||
| Insurance type | ||
| Public | 8056 (55.3) | 1 [Reference] |
| Private | 5733 (39.4) | 0.83 (0.79-0.86) |
| Other | 777 (5.3) | 0.73 (0.68-0.79) |
| Child Opportunity Index | ||
| Very low | 3752 (25.8) | 1 [Reference] |
| Low | 2224 (15.3) | 1.03 (0.98-1.09) |
| Moderate | 2522 (17.3) | 1.06 (1.00-1.12) |
| High | 2481 (17.0) | 1.07 (1.01-1.14) |
| Very high | 3587 (24.6) | 1.09 (1.03-1.16) |
| Urbanicity | ||
| Urban | 12 974 (89.1) | 1 [Reference] |
| Suburban | 1028 (7.1) | 1.01 (0.94-1.09) |
| Rural | 564 (3.9) | 0.85 (0.77-0.94) |
| Distance quartile | ||
| First (closest) | 4738 (32.5) | 1 [Reference] |
| Second | 3948 (27.1) | 0.89 (0.85-0.93) |
| Third | 3472 (23.8) | 0.76 (0.73-0.80) |
| Fourth (farthest) | 2408 (16.5) | 0.64 (0.60-0.68) |
| Child psychiatrists per 10 000 children, median (IQR) | 1.59 (1.25-2.93) | 0.98 (0.87-1.10) |
| Child psychologists per 10 000 children, median (IQR) | 1.76 (1.09-3.15) | 1.10 (0.98-1.24) |
| Need factors | ||
| Mental health diagnosis group | ||
| Suicidal ideation or self-harm | 2885 (19.8) | 1 [Reference] |
| Disorders | ||
| Mood | 3178 (21.8) | 1.03 (0.98-1.09) |
| Anxiety | 1799 (12.4) | 0.84 (0.79-0.89) |
| Disruptive or impulse control | 2161 (14.8) | 1.23 (1.15-1.30) |
| Trauma | 959 (6.6) | 0.87 (0.81-0.94) |
| Neurodevelopmental | 814 (5.6) | 1.06 (0.98-1.16) |
| Substance use | 336 (2.3) | 0.50 (0.45-0.56) |
| Somatic symptom | 170 (1.2) | 1.09 (0.93-1.27) |
| Eating | 111 (0.8) | 1.29 (1.07-1.56) |
| Psychotic | 99 (0.7) | 1.81 (1.48-2.22) |
| Other | 2054 (14.1) | 1.10 (1.04-1.17) |
| Multiple psychiatric comorbidities | ||
| No | 10 391 (71.3) | 1 [Reference] |
| Yes | 4175 (28.7) | 1.41 (1.35-1.46) |
| Complex chronic condition | ||
| No | 14 273 (98.0) | 1 [Reference] |
| Yes | 293 (2.0) | 0.95 (0.85-1.07) |
| Chemical restraint use | ||
| No | 14 336 (98.4) | 1 [Reference] |
| Yes | 230 (1.6) | 1.70 (1.49-1.94) |
| Day of presentation | ||
| Weekday | 12 248 (84.1) | 1 [Reference] |
| Weekend | 2318 (15.9) | 0.99 (0.95-1.04) |
| Hour of presentation | ||
| 8 am-4 pm | 6546 (44.9) | 1 [Reference] |
| 4 pm-12 am | 7052 (48.4) | 1.07 (1.03-1.10) |
| 12 am-8 am | 968 (6.6) | 1.00 (0.93-1.07) |
| Inpatient psychiatric unit | ||
| No | 3825 (26.3) | 1 [Reference] |
| Yes | 10741 (73.7) | 1.57 (1.27-1.94) |
Abbreviation: HR, hazard ratio.
a
Other included non-Hispanic patients who were American Indian, Pacific Islander, multiple, or other races.