View in EDS

Hospital-Based Quality Measures for Pediatric Mental Health Care.

Saved in:
Bibliographic Details
Title: Hospital-Based Quality Measures for Pediatric Mental Health Care.
Authors: Bardach, Naomi S., Burkhart, Q., Richardson, Laura P., Roth, Carol P., Murphy, J. Michael, Parast, Layla, Gidengil, Courtney A., Marmet, Jordan, Britto, Maria T., Mangione-Smith, Rita
Source: Pediatrics. Jun2018, Vol. 141 Issue 6, p1-11. 11p.
Subjects: Psychoses, Substance abuse diagnosis, Suicidal ideation, Black people, Caregivers, Children's hospitals, Communication, Counseling, Delphi method, Documentation, Health services accessibility, Health status indicators, Hospitals, Hospital emergency services, Medical records, Medical screening, Mental health services, Multivariate analysis, Pediatrics, Quality assurance, Race, Sex distribution, Statistics, Evidence-based medicine, Comorbidity, Patients' attitudes, Odds ratio, Children, Diagnosis
Abstract: BACKGROUND AND OBJECTIVES: Patients with a primary mental health condition account for nearly 10% of pediatric hospitalizations nationally, but little is known about the quality of care provided for them in hospital settings. Our objective was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. METHODS: We drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings. We used the modified Delphi method to prioritize measures; 2 ED and 6 inpatient measures were operationalized and field-tested in 2 community and 3 children's hospitals. Eligible patients were 5 to 19 years old and diagnosed with psychosis, suicidality, or substance use from January 2012 to December 2013. We used bivariate and multivariate models to examine measure performance by patient characteristics and by hospital. RESULTS: Eight hundred and seventeen records were abstracted with primary diagnoses of suicidality (n = 446), psychosis (n = 321), and substance use (n = 50). Performance varied across measures. Among patients with suicidality, male patients (adjusted odds ratio: 0.27, P < .001) and African American patients (adjusted odds ratio: 0.31, P = .02) were less likely to have documentation of caregiver counseling on lethal means restriction. Among admitted suicidal patients, 27% had documentation of communication with an outside provider, with variation across hospitals (0%-38%; P < .001). There was low overall performance on screening for comorbid substance abuse in ED patients with psychosis (mean: 30.3). CONCLUSIONS: These new pediatric mental health care quality measures were used to identify sex and race disparities and substantial hospital variation. These measures may be useful for assessing and improving hospital-based pediatric mental health care quality. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 130011553
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Hospital-Based Quality Measures for Pediatric Mental Health Care.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bardach%2C+Naomi+S%2E%22&quot;&gt;Bardach, Naomi S.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burkhart%2C+Q%2E%22&quot;&gt;Burkhart, Q.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Richardson%2C+Laura+P%2E%22&quot;&gt;Richardson, Laura P.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Roth%2C+Carol+P%2E%22&quot;&gt;Roth, Carol P.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Murphy%2C+J%2E+Michael%22&quot;&gt;Murphy, J. Michael&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Parast%2C+Layla%22&quot;&gt;Parast, Layla&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gidengil%2C+Courtney+A%2E%22&quot;&gt;Gidengil, Courtney A.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Marmet%2C+Jordan%22&quot;&gt;Marmet, Jordan&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Britto%2C+Maria+T%2E%22&quot;&gt;Britto, Maria T.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mangione-Smith%2C+Rita%22&quot;&gt;Mangione-Smith, Rita&lt;/searchLink&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Pediatrics%22&quot;&gt;Pediatrics&lt;/searchLink&gt;. Jun2018, Vol. 141 Issue 6, p1-11. 11p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Psychoses%22&quot;&gt;Psychoses&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Substance+abuse+diagnosis%22&quot;&gt;Substance abuse diagnosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Suicidal+ideation%22&quot;&gt;Suicidal ideation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Black+people%22&quot;&gt;Black people&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Caregivers%22&quot;&gt;Caregivers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Children&#39;s+hospitals%22&quot;&gt;Children&#39;s hospitals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Communication%22&quot;&gt;Communication&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Counseling%22&quot;&gt;Counseling&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Delphi+method%22&quot;&gt;Delphi method&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Documentation%22&quot;&gt;Documentation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Health+services+accessibility%22&quot;&gt;Health services accessibility&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Health+status+indicators%22&quot;&gt;Health status indicators&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospitals%22&quot;&gt;Hospitals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospital+emergency+services%22&quot;&gt;Hospital emergency services&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+records%22&quot;&gt;Medical records&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+screening%22&quot;&gt;Medical screening&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mental+health+services%22&quot;&gt;Mental health services&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multivariate+analysis%22&quot;&gt;Multivariate analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Pediatrics%22&quot;&gt;Pediatrics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Quality+assurance%22&quot;&gt;Quality assurance&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Race%22&quot;&gt;Race&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sex+distribution%22&quot;&gt;Sex distribution&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Statistics%22&quot;&gt;Statistics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Evidence-based+medicine%22&quot;&gt;Evidence-based medicine&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Comorbidity%22&quot;&gt;Comorbidity&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patients&#39;+attitudes%22&quot;&gt;Patients&#39; attitudes&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Odds+ratio%22&quot;&gt;Odds ratio&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Children%22&quot;&gt;Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnosis%22&quot;&gt;Diagnosis&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND AND OBJECTIVES: Patients with a primary mental health condition account for nearly 10% of pediatric hospitalizations nationally, but little is known about the quality of care provided for them in hospital settings. Our objective was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. METHODS: We drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings. We used the modified Delphi method to prioritize measures; 2 ED and 6 inpatient measures were operationalized and field-tested in 2 community and 3 children&#39;s hospitals. Eligible patients were 5 to 19 years old and diagnosed with psychosis, suicidality, or substance use from January 2012 to December 2013. We used bivariate and multivariate models to examine measure performance by patient characteristics and by hospital. RESULTS: Eight hundred and seventeen records were abstracted with primary diagnoses of suicidality (n = 446), psychosis (n = 321), and substance use (n = 50). Performance varied across measures. Among patients with suicidality, male patients (adjusted odds ratio: 0.27, P &lt; .001) and African American patients (adjusted odds ratio: 0.31, P = .02) were less likely to have documentation of caregiver counseling on lethal means restriction. Among admitted suicidal patients, 27% had documentation of communication with an outside provider, with variation across hospitals (0%-38%; P &lt; .001). There was low overall performance on screening for comorbid substance abuse in ED patients with psychosis (mean: 30.3). CONCLUSIONS: These new pediatric mental health care quality measures were used to identify sex and race disparities and substantial hospital variation. These measures may be useful for assessing and improving hospital-based pediatric mental health care quality. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=130011553
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1542/peds.2017-3554
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 1
    Subjects:
      – SubjectFull: Psychoses
        Type: general
      – SubjectFull: Substance abuse diagnosis
        Type: general
      – SubjectFull: Suicidal ideation
        Type: general
      – SubjectFull: Black people
        Type: general
      – SubjectFull: Caregivers
        Type: general
      – SubjectFull: Children's hospitals
        Type: general
      – SubjectFull: Communication
        Type: general
      – SubjectFull: Counseling
        Type: general
      – SubjectFull: Delphi method
        Type: general
      – SubjectFull: Documentation
        Type: general
      – SubjectFull: Health services accessibility
        Type: general
      – SubjectFull: Health status indicators
        Type: general
      – SubjectFull: Hospitals
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Medical screening
        Type: general
      – SubjectFull: Mental health services
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Pediatrics
        Type: general
      – SubjectFull: Quality assurance
        Type: general
      – SubjectFull: Race
        Type: general
      – SubjectFull: Sex distribution
        Type: general
      – SubjectFull: Statistics
        Type: general
      – SubjectFull: Evidence-based medicine
        Type: general
      – SubjectFull: Comorbidity
        Type: general
      – SubjectFull: Patients' attitudes
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Diagnosis
        Type: general
    Titles:
      – TitleFull: Hospital-Based Quality Measures for Pediatric Mental Health Care.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Bardach, Naomi S.
      – PersonEntity:
          Name:
            NameFull: Burkhart, Q.
      – PersonEntity:
          Name:
            NameFull: Richardson, Laura P.
      – PersonEntity:
          Name:
            NameFull: Roth, Carol P.
      – PersonEntity:
          Name:
            NameFull: Murphy, J. Michael
      – PersonEntity:
          Name:
            NameFull: Parast, Layla
      – PersonEntity:
          Name:
            NameFull: Gidengil, Courtney A.
      – PersonEntity:
          Name:
            NameFull: Marmet, Jordan
      – PersonEntity:
          Name:
            NameFull: Britto, Maria T.
      – PersonEntity:
          Name:
            NameFull: Mangione-Smith, Rita
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 06
              Text: Jun2018
              Type: published
              Y: 2018
          Identifiers:
            – Type: issn-print
              Value: 00314005
          Numbering:
            – Type: volume
              Value: 141
            – Type: issue
              Value: 6
          Titles:
            – TitleFull: Pediatrics
              Type: main
ResultId 1