{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T17:10:24Z","timestamp":1758042624569,"version":"3.44.0"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Eating disorders (EDs) are serious mental illnesses that affect youth of all socioeconomic backgrounds. However, low-income, publicly insured youth with EDs face substantial barriers to adequate treatment and often experience repeated hospitalizations with significant costs to families and care systems. We examined whether increased outpatient psychotherapy following hospitalization could break these \u201crevolving door\u201d cycles of admissions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Participants were California Medicaid enrollees aged 7 to 18\u00a0years with diagnosed EDs who were hospitalized at least once (N\u2009=\u2009920). We used Cox proportional hazard models to examine whether the amount of outpatient therapy youth received in the 90\u00a0days after hospitalization predicted rehospitalization in the subsequent 90\u00a0days, covarying demographic characteristics, ED diagnosis, admission length and type (primarily medical\/psychiatric), and amount of outpatient therapy in the 90\u00a0days preceding admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Relative to youth who received 0 to 3 sessions of outpatient therapy in the 90\u00a0days after hospitalization, those who received 4 to 7 sessions had significantly reduced readmission risk in the subsequent 90\u00a0days (hazard ratio [HR] =\u20090.46; 95% CI, 0.23\u20130.91; P\u2009=\u2009.026). Risk was further reduced for youth who received 8 or more sessions (nearly weekly) (HR\u2009=\u20090.04; 95% CI, 0.004\u20130.34; P\u2009=\u2009.003). Cost savings associated with 8 or more therapy sessions were estimated at nearly $70\u2009000 per youth. However, only a small minority of the population (4.5%) received at least 8 sessions, with the modal number of sessions being zero.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Even a moderate amount of outpatient therapy may substantially reduce rehospitalization in publicly insured youth with EDs, decreasing morbidity and costs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2025-070797","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:02:21Z","timestamp":1753401741000},"source":"Crossref","is-referenced-by-count":0,"title":["Outpatient Therapy and Risk of\u00a0Rehospitalization for Youth With\u00a0Eating Disorders"],"prefix":"10.1542","volume":"156","author":[{"given":"Megan E.","family":"Mikhail","sequence":"first","affiliation":[{"name":"1Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California"},{"name":"2Department of Psychology, Michigan State University, East Lansing, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Duggento Cordell","sequence":"additional","affiliation":[{"name":"3Mental Health Data Alliance, Folsom, California"},{"name":"4Center for Innovation in Population Health, University of Kentucky, Lexington, Kentucky"},{"name":"5Social Policy Institute, San Diego State University, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda E.","family":"Downey","sequence":"additional","affiliation":[{"name":"1Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California"},{"name":"6Department of Pediatrics, University of California San Francisco, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lonnie R.","family":"Snowden","sequence":"additional","affiliation":[{"name":"7School of Public Health, University of California, Berkeley, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin C.","family":"Accurso","sequence":"additional","affiliation":[{"name":"1Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California"},{"name":"8Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"issue":"1","key":"2025091113124516500_r1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.psychres.2014.05.002","article-title":"Quality of life in eating disorders: a meta-analysis","volume":"219","author":"Winkler","year":"2014","journal-title":"Psychiatry Res."},{"issue":"10211","key":"2025091113124516500_r2","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1016\/S0140-6736(19)32316-5","article-title":"A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study","volume":"394","author":"Plana-Ripoll","year":"2019","journal-title":"Lancet."},{"issue":"5","key":"2025091113124516500_r3","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1093\/ajcn\/nqy342","article-title":"Prevalence of eating disorders over the 2000\u20132018 period: a systematic literature review","volume":"109","author":"Galmiche","year":"2019","journal-title":"Am J Clin Nutr."},{"volume-title":"Social and Economic Cost of Eating Disorders in the United States of America: Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders","year":"2020","author":"Deloitte Access Economics","key":"2025091113124516500_r4"},{"issue":"5","key":"2025091113124516500_r5","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/eat.23486","article-title":"Social and economic cost of eating disorders in the United States: evidence to inform policy action","volume":"54","author":"Streatfeild","year":"2021","journal-title":"Int J Eat Disord."},{"issue":"1","key":"2025091113124516500_r6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1001\/jamapediatrics.2020.3359","article-title":"Short-term outcomes of the Study of Refeeding to Optimize Inpatient Gains for patients with anorexia nervosa","volume":"175","author":"Garber","year":"2021","journal-title":"JAMA Pediatr."},{"issue":"2","key":"2025091113124516500_r7","doi-asserted-by":"crossref","first-page":"E192","DOI":"10.9778\/cmajo.20140086","article-title":"Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives","volume":"3","author":"Toulany","year":"2015","journal-title":"CMAJ Open."},{"key":"2025091113124516500_r8","doi-asserted-by":"crossref","first-page":"104857","DOI":"10.1016\/j.neubiorev.2022.104857","article-title":"Treatment of eating disorders: a systematic meta-review of meta-analyses and network meta-analyses","volume":"142","author":"Monteleone","year":"2022","journal-title":"Neurosci Biobehav Rev."},{"issue":"1","key":"2025091113124516500_r9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40337-022-00730-7","article-title":"Disparities in access to eating disorders treatment for publicly-insured youth and youth of color: a retrospective cohort study","volume":"11","author":"Moreno","year":"2023","journal-title":"J Eat Disord."},{"key":"2025091113124516500_r10","first-page":"17","article-title":"Equitable access to evidence-based treatment for eating disorders for patients with low-income: identifying barriers and exploring solutions","author":"Bailey-Straebler","year":"2024","journal-title":"Cogn Behav Therap."},{"key":"2025091113124516500_r11","doi-asserted-by":"crossref","first-page":"101548","DOI":"10.1016\/j.eatbeh.2021.101548","article-title":"Diseases of affluence? 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