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Age Affects the Impact of Important Predictors on Mental Health Emergency Department Visits

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Abstract

Visits to emergency departments (EDs) for pediatric mental health care have increased over the years. The likelihood of ED re-visit is greatest for older children; however, little is known about age-varying effects on ED visits/re-visits. This study used population-based administrative databases from Alberta, Canada, to investigate the association of predictors on mental health ED visit frequency by age for 27,947 children who presented at least once for mental health care from April 2002 to March 2011. A marginal regression model with age-varying effects for sex, geographic area, and socio-demographic group was fit. The impact of predictors depended on a child’s age. Notably, older males had lower ED visit frequencies compared to females (age 15 adjusted hazard ratio [aHR] = 0.70, 95% confidence interval [CI] [0.65, 0.76]) than younger males (age 10 aHR = 1.83, 95% CI [1.50, 2.24]). Children with particular ages for some socio-demographic groups also showed higher ED frequencies than children from the non-subsidized group. The analysis revealed important age-varying effects on predictors of mental health ED visit frequency.

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Acknowledgements

The authors thank Alberta Health for facilitating access to the data. We thank Jueyu Gao M.Sc. for his assistance in computer code development.

Funding

This work was financially supported by an operating grant from the Canadian Institutes of Health Research (CIHR; Ottawa, Canada). During this work, Dr. Rosychuk was salary supported by Alberta Innovates-Health Solutions (AI-HS; Edmonton, Canada) as a Health Scholar. Dr. Newton holds a CIHR New Investigator Award.

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Authors and Affiliations

  1. Department of Pediatrics, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada

    Rhonda J. Rosychuk PhD & Amanda S. Newton PhD, RN

  2. Women & Children’s Health Research Institute, Edmonton, Alberta, Canada

    Rhonda J. Rosychuk PhD & Amanda S. Newton PhD, RN

  3. Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia, Canada

    X. Joan Hu PhD

Authors
  1. Rhonda J. Rosychuk PhD
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  2. Amanda S. Newton PhD, RN
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  3. X. Joan Hu PhD
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Corresponding author

Correspondence to Rhonda J. Rosychuk PhD.

Ethics declarations

The University of Alberta Health Research Ethics Board approved this research and individual participant informed consent was not required.

Conflict of Interest

The authors declare that they have no conflict of interest.

Data and Computing Code

Data is the property of Alberta Health and the authors are not allowed to provide the data. Requests can be made for the same data from Alberta Health for researchers who meet the criteria for access to confidential data. Researchers are welcome to inquire for further information at Health.RESDATA@gov.ab.ca. R code for the method is available at http://onlinelibrary.wiley.com/doi/10.1111/biom.12503/suppinfo.

Disclaimer

This study is based in part on data provided by Alberta Health. The interpretation and conclusions are contained herein are those of the researchers and do not necessarily represent the views of the Government of Alberta. Neither the government nor Alberta Health expresses any opinion in relation to this study.

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Rosychuk, R.J., Newton, A.S. & Hu, X. Age Affects the Impact of Important Predictors on Mental Health Emergency Department Visits. J Behav Health Serv Res 46, 625–635 (2019). https://doi.org/10.1007/s11414-018-9642-7

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  • DOI: https://doi.org/10.1007/s11414-018-9642-7

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