SHM Converge Scientific Abstract ePoster Gallery-Hospital-Level Factors Associated With Length of Stay for Children Hospitalized Due to Suicide Attempt or Self-Injury Among Us Children's Hospitals

Hospital-Level Factors Associated With Length of Stay for Children Hospitalized Due to Suicide Attempt or Self-Injury Among Us Children's Hospitals

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This retrospective cohort study examined length of stay (LOS) for children ages 5–18 hospitalized for suicide attempt or self-injury (SA/SI) across 43 U.S. children’s hospitals using the PHIS database and Children’s Hospital Association benchmark data from 2022–2023. The study excluded surgical cases, direct psychiatric admissions, and deaths. Researchers adjusted for patient factors such as age, sex, race, payor, and illness severity, then used generalized estimating equations to assess hospital-level factors associated with LOS.<br /><br />The study found substantial variation in adjusted mean LOS across hospitals, indicating that where a child is hospitalized may meaningfully affect time spent in the hospital. Two key hospital-level factors were associated with LOS: hospitals with Child and Adolescent Psychiatry specialists tended to have longer LOS, while hospitals with inpatient psychiatric residential treatment programs had shorter LOS. Hospitals were considered outliers if their 95% confidence interval for adjusted LOS did not include the overall mean.<br /><br />The authors concluded that hospital resources and psychiatric care infrastructure likely influence LOS for pediatric SA/SI admissions. They suggested the findings could help hospitals identify opportunities to improve care efficiency and resource use, and support policy efforts to expand access to inpatient psychiatric treatment programs or improve transitions to psychiatric care outside children’s hospitals.<br /><br />Important limitations included the retrospective design, limited detail on hospital resources available from annual survey data, inability to account for non-hospital-based local resources, and limited generalizability to non-free-standing children’s hospitals.

Asset Subtitle

Cory Alexieff

Meta Tag

Author List Adrienne DePorre, Cory Alexieff, Daniel A. Rauch, Jamie M. Pinto, Jay Berry, Matt Hall, Yen-Hong Kuo

Category Research

Concept Adjusted Length of Stay

Concept Pediatric Suicide Attempt

Concept Self-Injury

Concept Hospital-Level Factors

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization K. Hovnanian Children's Hospital at Jersey Shore University Medical Center

Presenting Author Cory Alexieff

Track Pediatric

Keywords

pediatric suicide attempt

self-injury

length of stay

children’s hospitals

PHIS database

hospital variation

psychiatry specialists

psychiatric residential treatment

hospital resources

retrospective cohort study

Adjusted Length of Stay

Pediatric Suicide Attempt

Self-Injury

Hospital-Level Factors

Retrospective Cohort Study