581 - Pediatric Inpatient Psychiatric Service Availability in the United States

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 581
Publication Number: 581.222

Anna M. Cushing, Children's Hospital Los Angeles, Los Angeles, CA, United States; Katherine Nash, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Ashley A.. Foster, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Kenneth Michelson, Boston Children's Hospital, Boston, MA, United States; Jennifer A. Hoffmann, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States

Presenting Author(s)

Anna M. Cushing, MD (she/her/hers)

Pediatric Emergency Medicine Fellow
Children's Hospital Los Angeles
Los Angeles, California, United States

Background: Demand for pediatric inpatient psychiatric care is growing. Children increasingly visit the emergency department for mental and behavioral health emergencies and often have prolonged lengths of stay while awaiting an inpatient psychiatric bed. There are large disparities in geographic availability of outpatient pediatric mental health care for rural compared to urban children. However, the availability and geographic distribution of pediatric inpatient psychiatric units is not yet known. Better understanding of the availability and geographic variation in pediatric inpatient psychiatric services is needed for improved health services planning.

Objective: Our objectives were to describe the availability and geographic variation in pediatric inpatient psychiatric services in the United States and to determine if inequities exist in availability of pediatric inpatient psychiatric services by geographic area.

Design/Methods: We used data from the 2017-2020 American Hospital Association database to estimate the number of pediatric psychiatric units and beds in the United States. We report the availability of pediatric inpatient psychiatric units and beds for the most recent data year (2020). We assessed geographic variation in pediatric inpatient psychiatric beds per capita by state using population data from the 2015-2019 American Community Survey.

Results: There were 453 hospitals with pediatric inpatient psychiatric units in 2020 and 11,276 pediatric inpatient psychiatric beds reported in 2020 (Table 1). There were a median of 20 (IQR 12, 32) pediatric inpatient psychiatric beds per hospital with available bed counts. The majority of hospitals with a pediatric inpatient psychiatric unit were non-teaching [355 (78.4%)], non-profit [246 (54.3%)], and located in urban areas [399 (88.1%)]. Most pediatric inpatient psychiatric units were in general medical hospitals [240 (53.0%)] rather that children’s or psychiatric hospitals. Pediatric inpatient psychiatric bed capacity varied by state (Figure 1). One state, Alaska, had no pediatric inpatient psychiatric units. Of states with pediatric inpatient psychiatric beds, the number of beds per capita ranged from 1.5 to 75.3, with a median of 15.3, per 100,000 children.

Conclusion(s):

There is large geographic variation in access to pediatric inpatient psychiatric services. Further study is needed to determine whether geographic inequities in access to inpatient pediatric psychiatric services are associated with patient outcomes.