{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:49:40Z","timestamp":1788576580144,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Pediatric mental illness poses a significant burden with an overall prevalence of approximately 10%. Increasingly, children with mental disorders seek care in the emergency department (ED). However, the ED is not an ideal setting. Pediatric mental health patients receive limited treatment and experience significantly longer length of stay (LOS) than other patients seen in the ED. This study examines patient and hospital factors associated with LOS and prolonged LOS (PLOS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a retrospective chart review of patients between the ages of 3 and 17 presenting at 2 participating urban EDs with a psychiatric diagnosis from May 2010 to May 2012.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>This study includes 939 patients with an average age of 14.1 years and a median LOS of 295 minutes. The diagnosis was the strongest predictor of LOS and PLOS. Patients with a psychotic disorder or suicide attempt or ideation experienced a longer LOS, 35% and 55% increases, respectively, and an increased odds of PLOS (odds ratio, 3.07 and 8.36, respectively). Patient sex, previous history of self-harm, and the daily census were associated with both a longer LOS and PLOS. Ethnicity, site of admission, and year of admission were only associated with LOS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Diagnosis-specific management factors are the primary determinant of LOS. However, some patient characteristics and hospital operational factors are also associated with LOS. Organizational reforms and an evaluation of the required human and material resources are necessary to improve access to and availability of pediatric mental health care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000000509","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T14:53:08Z","timestamp":1443538388000},"page":"613-619","source":"Crossref","is-referenced-by-count":21,"title":["Determinants of Pediatric Psychiatry Length of Stay in 2 Urban Emergency Departments"],"prefix":"10.1097","volume":"33","author":[{"given":"Bharath","family":"Chakravarthy","sequence":"first","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Yang","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzor","family":"Ogbu","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Kim","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anum","family":"Iqbal","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Haight","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Anderson","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"DiMassa","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Bruckner","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Bhargava","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merrit","family":"Schreiber","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahram","family":"Lotfipour","sequence":"additional","affiliation":[{"name":"From the *Department of Emergency Medicine, University of California, Irvine Health School of Medicine, Orange; \u2020Department of Emergency Medicine, Long Beach Memorial Medical Center, Long Beach; and \u2021Department of Social Ecology, University of California Irvine, Irvine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"Suppl 2","key":"bib1-20231023","first-page":"1","article-title":"Mental health surveillance among children\u2014United States, 2005-2011","volume":"62","year":"2013","journal-title":"MMWR Surveill Summ"},{"key":"bib3-20231023","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1542\/peds.2008-2598","article-title":"Prevalence and treatment of mental disorders among US children in the 2001\u20132004 NHANES","volume":"125","year":"2010","journal-title":"Pediatrics"},{"key":"bib5-20231023","first-page":"1","article-title":"National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary","volume":"26","year":"2010","journal-title":"Natl Health Stat Report"},{"key":"bib6-20231023","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1176\/appi.ps.56.6.671","article-title":"Trends in U.S. emergency department visits for mental health conditions, 1992 to 2001","volume":"56","year":"2005","journal-title":"Psychiatr Serv"},{"key":"bib7-20231023","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.annemergmed.2008.11.024","article-title":"The effect of hospital bed occupancy on throughput in the pediatric emergency department","volume":"53","year":"2009","journal-title":"Ann Emerg Med"},{"key":"bib8-20231023","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s10916-009-9307-4","article-title":"The impact of inpatient boarding on ED efficiency: a discrete-event simulation study","volume":"34","year":"2010","journal-title":"J Med Syst"},{"key":"bib9-20231023","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1097\/MLR.0000000000000141","article-title":"Emergency department crowding predicts admission length-of-stay but not mortality in a large health system","volume":"52","year":"2014","journal-title":"Med Care"},{"key":"bib10-20231023","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.jemermed.2012.01.064","article-title":"Pitfalls in the care of the psychiatric patient in the emergency department","volume":"43","year":"2012","journal-title":"J Emerg Med"},{"key":"bib11-20231023","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/01.pec.0000199568.94758.6e","article-title":"Children requiring psychiatric consultation in the pediatric emergency department: epidemiology, resource utilization, and complications","volume":"22","year":"2006","journal-title":"Pediatr Emerg Care"},{"key":"bib12-20231023","doi-asserted-by":"crossref","first-page":"e1356","DOI":"10.1542\/peds.2011-0522","article-title":"Pediatric and adolescent mental health emergencies in the emergency medical services system","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"bib13-20231023","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/PEC.0b013e31820d644b","article-title":"A retrospective look at length of stay for pediatric psychiatric patients in an urban emergency department","volume":"27","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"bib14-20231023","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.jaac.2011.08.011","article-title":"Length of stay of pediatric mental health emergency department visits in the United States","volume":"50","year":"2011","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"bib15-20231023","first-page":"360308","article-title":"The impact of psychiatric patient boarding in emergency departments","volume":"2012","year":"2012","journal-title":"Emerg Med Int"},{"key":"bib16-20231023","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/PEC.0b013e31821d8571","article-title":"Predictors of psychiatric boarding in the pediatric emergency department: implications for emergency care","volume":"27","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"bib17-20231023","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/acem.12282","article-title":"Trends in pediatric visits to the emergency department for psychiatric illnesses","volume":"21","year":"2014","journal-title":"Acad Emerg Med"},{"key":"bib18-20231023","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/PEC.0b013e31821314ca","article-title":"Exploring differences in the clinical management of pediatric mental health in the emergency department","volume":"27","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"bib19-20231023","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","year":"2009","journal-title":"J Biomed Inform"},{"key":"bib20-20231023","doi-asserted-by":"crossref","first-page":"629","DOI":"10.2307\/3053175","article-title":"Involuntary commitment for mental disorder: the application of California\u2019s Lanterman-Petris-Short Act","volume":"11","year":"1977","journal-title":"Law Soc Rev"},{"key":"bib22-20231023","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1097\/00004583-199605000-00021","article-title":"Enhancing treatment adherence with a specialized emergency room program for adolescent suicide attempters","volume":"35","year":"1996","journal-title":"J Am Acad Child Adolesc Psychiatry"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201709000-00002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T02:07:36Z","timestamp":1698026856000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201709000-00002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000000509","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,9]]}}}