{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:20:14Z","timestamp":1790180414737,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T00:00:00Z","timestamp":1605398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study examined factors related to hospital length of stay (LOS), reported referral on discharge, and hospital readmission, for children and adolescents (C&amp;A) admitted to public hospitals for anorexia nervosa (AN), in a large health jurisdiction in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Sociodemographic, illness, treatment, and hospital factors associated with LOS, reported referral to post\u2010hospital treatment, and readmission within 28\u2009days were analyzed for C&amp;A with AN admitted to all New South Wales public hospitals in 2017, using median, multinomial logit and logit models. The sample comprised 289 admissions by 200 C&amp;A aged 9\u201318\u2009years with a primary or secondary diagnosis of AN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AN as a primary diagnosis and the presence of some physical and mental co\u2010occurring conditions (e.g., malnutrition and obsessive\u2013compulsive disorders) conferred a longer LOS. The majority of admissions were recorded being referred to primary care physicians (59.86%) and relatively small numbers to outpatient mental health services (5.54%) or outpatient eating disorder services (8.30%), with age, area socioeconomic status, and illness factors related to referral type. Male, low socioeconomic status, the presence of some co\u2010occurring illnesses (e.g., adjustment disorder and viral infection), and rural or remote locations increased the likelihood of readmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The findings have implications for service design, in particular the pathway to care from hospital into community for AN. Targeted interventions should consider recognizing and treating physical co\u2010occurring illnesses at presentation to the health system, ensuring appropriate referral to community services, and providing services in socioeconomically disadvantaged and rural or remote areas.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23399","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T06:33:41Z","timestamp":1605508421000},"page":"409-421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Factors related to length of stay, referral on discharge and hospital readmission for children and adolescents with anorexia nervosa"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6269-6432","authenticated-orcid":false,"given":"Ang","family":"Li","sequence":"first","affiliation":[{"name":"Boden Collaboration for Obesity, Nutrition and Eating Disorders, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Health Economics Collaborative, Sydney Local Health District  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Cunich","sequence":"additional","affiliation":[{"name":"Boden Collaboration for Obesity, Nutrition and Eating Disorders, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Health Economics Collaborative, Sydney Local Health District  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Miskovic\u2010Wheatley","sequence":"additional","affiliation":[{"name":"InsideOut Institute of Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Maloney","sequence":"additional","affiliation":[{"name":"InsideOut Institute of Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sloane","family":"Madden","sequence":"additional","affiliation":[{"name":"Eating Disorder Service, Sydney Children's Hospitals Network  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0486-7686","authenticated-orcid":false,"given":"Andrew","family":"Wallis","sequence":"additional","affiliation":[{"name":"Eating Disorder Service, Sydney Children's Hospitals Network  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Maguire","sequence":"additional","affiliation":[{"name":"InsideOut Institute of Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.06.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70232-X"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"624","article-title":"Understanding barriers to mental health service utilization for adolescents in rural Australia","volume":"7","author":"Aisbett D.","year":"2007","journal-title":"Rural Remote Health"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.153"},{"issue":"4","key":"e_1_2_10_9_1","first-page":"40","article-title":"Improving medical care for persons with serious mental illness: Challenges and solutions","volume":"68","author":"Druss B. 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