Evaluation and Disposition of Medicaid-Insured Children and Adolescents With Suicide Attempts.
OBJECTIVE: Guidelines and quality of care measures for the evaluation of adolescent suicidal behavior recommend prompt mental health evaluation, hospitalization of high-risk youth, and specific follow-up plans—all of which may be influenced by sociodemographic factors. The aim of this study was to i...
| Publicado en: | Academic Pediatrics Vol. 15; no. 1; pp. 36 - 41 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Jan/Feb2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107812319&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107812319 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18762859 8NBK jtl: Academic Pediatrics issn: 18762859 maglogo: N pubinfo: dt: Jan/Feb2015 vid: 15 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 107812319 100367534 100367534 10.1016/j.acap.2014.04.005 NLM24942933 107812319 ppf: 36 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Evaluation and Disposition of Medicaid-Insured Children and Adolescents With Suicide Attempts. aug: au: Williams, Candice L. Cooper, William O. Balmer, Leanne S. Dudley, Judith A. Gideon, Patricia S. DeRanieri, Michelle M. Stratton, Shannon M. Callahan, S. Todd affil: Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn sug: subj: Suicidal Ideation Evaluation Patient Assessment Case Management Human Tennessee Child Adolescence Medicaid Guideline Adherence Socioeconomic Factors Academic Medical Centers Chi Square Test Logistic Regression After Care Confidence Intervals Retrospective Design Record Review Data Analysis Software Multivariate Analysis Male Female Descriptive Statistics Funding Source Child: 6-12 years Adolescent: 13-18 years Male Female ab: OBJECTIVE: Guidelines and quality of care measures for the evaluation of adolescent suicidal behavior recommend prompt mental health evaluation, hospitalization of high-risk youth, and specific follow-up plans—all of which may be influenced by sociodemographic factors. The aim of this study was to identify sociodemographic characteristics associated with variations in the evaluation of youth with suicidal behavior. METHODS: We conducted a large cohort study of youth, aged 7 to 18, enrolled in Tennessee Medicaid from 1995 to 2006, who filled prescriptions for antidepressants and who presented for evaluation of injuries that were determined to be suicidal on the basis of external cause-of-injury codes (E codes) and ICD- 9-CM codes and review of individual medical records. Chisquare tests and logistic regression were performed to assess the relationship between sociodemographic characteristics and documentation of mental health evaluation, hospitalization, and discharge instructions. RESULTS: Of 929 episodes of suicidal behavior evaluated in an acute setting, rural-residing youth were less likely to be admitted to a psychiatric hospital (adjusted odds ratio [AOR] 0.72; 95% confidence interval [Cl] 0.55-0.95) and more likely to be medically hospitalized only (AOR 1.92; 95% Cl 1.39- 2.65). Female subjects were less likely to be admitted to a psychiatric hospital (AOR 0.55; 95% Cl 0.41-0.74) and more likely to be discharged home (AOR 1.44; 95% Cl 1.01-2.04). Only 40% of those discharged to home had documentation of discharge instructions with both follow-up provider and date. CONCLUSIONS: In this statewide cohort of youth with suicidal behavior, there were significant differences in disposition associated with sociodemographic characteristics. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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